Upgrade to remove ads
Only $2.99/month

Dynamics Chapter 19 Vocab

Terms in this set (40)

Acute illness
A disease or condition that comes on rapidly and severely but can be cured with proper treatment such as broken bones, wounds requiring stitches, pneumonia
Appeal
A special kind of complaint made if you disagree with decisions made by Medicare or your health plan
Benefit
Medical care or equipment that is covered by your health insurance or health care plan
Beneficiary
A person who has health care insurance through health care plans such as the Medicare and Medicaid programs
TRICARE
Health care program for active duty and retired military personnel and their family members.
SSI (Supplementary Security Income)
Monthly benefits for people with low incomes, and assets who are older than 65, blind, or have a disability. Includes Medicaid coverage.
Specialist
A doctor who specializes in treating only a certain part of the body or a certain condition, such as a cardiologist (heart doctor) or nephrologist (kidney doctor).
Skilled Nursing Facility
A Medicare-approved facility which provides a short-term post-hospital extended care services, at a lower level of care than hospital care.
Skilled Care
Medically reasonable and necessary care performed by a skilled nurse or therapist.
Rehabilitative Care
The care of patients with the intent of curing, improving or preventing a worsening of their condition.
Premium
The amount of money an individual who wants health care coverage must pay to an insurer, health plan or Medicare.
Pre-Existing Condition
A condition or illness you were diagnosed with or got treatment for before your new health care coverage began.
Power of Attorney
Legal document that lets you appoint another person to make property, financial, legal, and health care decisions related to insurance and spending on your behalf.
Physical Therapy
Exercise and physical activities used to condition muscles and improve levels of activity.
PCP (Primary Care Physician)
The doctor that manages your care and refers you to specialty care if needed.
Outpatient Care
Medical care that does not require an overnight hospital stay.
Personal Care
Assistance with activities of daily living such as bathing, feeding, and toileting.
Out-of-Pocket-Costs
Health care costs that you must pay because Medicare or other insurance does not cover them.
Medicare Part D
Prescription drug coverage that helps pay for medications doctors prescribe for treatment. Enrollment is voluntary and an additional monthly premium must be paid.
Medicare Part C
Also known as Medicare Advantage it is a coordinated care plan for individuals who are entitled to Part A and enrolled in Part B which provides all health care services through one provider.
Medicare Part B
Medical insurance that helps pay for doctor's services and many other medical services not covered by Medicare.
Medicare Part A
Hospital insurance for citizens 65 and older (permanently disabled with work credits, blind and End stage renal disease persons) that provides basic coverage for hospital stays, nursing facility stays, and home health care.
Medicaid
A federally funded, state-run program that covers medical expenses for people with low or limited incomes.
Health Insurance
A protection purchased to help pay for medical expenses related to health or sickness
Inpatient Care
Care for a person in the hospital overnight.
Hospice
Comprehensive care for people who are terminally ill including pain management, counseling, prescription drugs, inpatient and out patient services, and services for the terminally ill person's family.
Home Health Care
Care provided at home to treat an illness or injury.
Home Health Aide
a worker who helps a patient at home with daily living activities.
Home Health Agency
An organization that provides home care services, such as skilled nursing care.
HMO (Health Maintenance Organization)
a type of managed care that generally covers only the care you get from doctors, hospitals, and other health care providers that are in the HMO network.
HIPAA
The Health Insurance Portability and Accountability Act provides new rights and protections for members of group health care plans.
Health Care Proxy
Legal document that allows you to appoint another person to make healthcare decisions for you.
Health Care Provider
An individual or facility such as a doctor or hospital, which provides health care services.
Generic Drug
A copy of a brand-name drug that is the same as a brand-name drug but cheaper.
Enrollment
Joining Medicare or becoming a member of a private health plan like a Medicare HMO.
Durable Medical Equipment (DME)
Equipment that is primarily serving a medical purpose, is able to withstand repeated use, and is appropriate for use in the home; for example wheelchairs, walkers, and hospital beds.
Denial of Coverage
A refusal by Medicare or a private plan to pay for medical services that are not covered under the policy.
Deductible
The amount of health care expenses you must pay before your health plan or Medicare begins to pay.
Co-payment
In some Medicare plans the amount you pay for each medical service like a doctor's visit or a prescription
Benefit period
The amount of time which Medicare pays for hospital and skilled nursing facility services.
YOU MIGHT ALSO LIKE...