Understanding Medicare means understanding the meaning of many unfamiliar terms. The following is a list of words and acronyms that are used when discussing Medicare, or are important to give you a better understanding of how Medicare works.

  • Activities of Daily Living (ADL)
  • Acute Illness
  • Administrative Law Judge (ALJ)
  • Advance Beneficiary Notice (ABN)
  • Advance Coverage Decision
  • Advance Directive
  • Advanced Illness
  • Affordable Care Act (also known as the Health Care Law)
  • ALS (Amyotrophic Lateral Sclerosis)/Lou Gehrig’s Disease
  • Ambulette
  • Annual Coordinated Election Period (ACEP)
  • Annual Notice of Change (ANOC)
  • Annual Wellness Visit
  • Appeal
  • Approved Amount
  • Area Agency on Aging (AAA)
  • Assets
  • Assignment
  • Assisted Living Facility
  • Assistive Technology
  • Balance Billing
  • Benchmark
  • Beneficiary
  • Benefit Period
  • Bereavement Services
  • Brand-Name Drug
  • Calendar Quarters
  • Capped Rental Item
  • Care Manager
  • Caregiver
  • Carrier
  • Catastrophic Coverage
  • Catastrophic Limit
  • Center for Health Dispute Resolution (CHDR)
  • Centers for Medicare & Medicaid Services (CMS)
  • Certificate of Medical Necessity (CMN)
  • Chronic Illness
  • Claim
  • COBRA (Consolidated Omnibus Budget Reconciliation Act)
  • Coinsurance
  • Competitive Bidding
  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Continuous Open Enrollment
  • Conversion Policy
  • Coordination of Benefits
  • Coordination Period, 30-Month
  • Copayment
  • Cost Plan
  • Cost Sharing
  • Cost Tiers
  • Coverage Gap
  • Coverage Restrictions
  • Creditable Coverage
  • Crossover
  • Curative Care
  • Currently Working
  • Custodial Care
  • Deductible
  • Demand Bill
  • Denial of Coverage
  • Department of Veterans Affairs (VA)
  • Detailed Explanation of Non-Coverage (DENC)
  • Detailed Notice of Discharge
  • Dialysis
  • Disability
  • Discharge
  • Discharge Plan
  • Disenrollment
  • DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics and Supplies)
  • Donut Hole
  • Drug Class
  • Drug Tiers
  • Dual Eligible
  • Durable Medical Equipment (DME)
  • Durable Medical Equipment Medicare Administrative Contractor (DME MAC)
  • Durable Medical Equipment Regional Carrier (DMERC)
  • Durable Power of Attorney
  • Earned Income
  • Elimination Period See
  • Employer Group Health Plan
  • End-Stage Renal Disease (ESRD)
  • Enrollment
  • Enrollment Periods
  • Evidence of Coverage (EOC)
  • Exception Request
  • Excess Charges
  • Expedited Appeal
  • Explanation of Benefits (EOB)
  • Extra Help
  • Extra Help Premium Amount
  • Fall Open Enrollment
  • Federal District Court
  • Federal Employee Health Benefit Program (FEHBP)
  • Federal Poverty Level (FPL)
  • Federally Qualified Health Center (FQHC)
  • Fee-for-Service
  • Fiscal Intermediary
  • Formulary
  • Formulary Restrictions
  • Free Look
  • Gaps in Coverage
  • Gatekeeper
  • General Enrollment Period
  • Generic Drug
  • Grievance
  • Group Health Plan
  • Guaranteed Issue
  • Health Care Financing Administration (HCFA)
  • Health Care Power of Attorney
  • Health Care Provider
  • Health Care Proxy
  • Health Insurance
  • Hill-Burton Program/Facilities
  • HIPAA
  • HMO (Health Maintenance Organization)
  • Home Health Agency
  • Home Health Aide
  • Home Health Care
  • Homebound
  • Homemaking Services
  • Hospice
  • Hospital Insurance
  • Hospital-Issued Notice of Non-Coverage (HINN)
  • Housekeeping Services
  • Important Message from Medicare
  • In-Network
  • Independent Review Entity (IRE)
  • Individual Policy
  • Initial Coverage Election Period
  • Initial Enrollment Period
  • Initial Open Enrollment Period
  • Inpatient
  • Inpatient Care
  • Intermediary
  • Intermediate Care Facility for the Mentally Retarded (ICF/MR)
  • Language Therapy
  • Lifetime Reserve Days
  • Limiting Charge
  • Living Will
  • Long-Term Care
  • Long-Term Care Insurance
  • Long-Term Care Ombudsman
  • Low-Income Subsidy (LIS)
  • Maintenance Care
  • Managed Care Plan
  • MAPD (Medicare Advantage Drug Plan)
  • Marketing Fraud
  • Marketplaces (also known as Exchanges)
  • Maximum Out-of-Pocket Cost (MOoP)
  • Maximus
  • Medicaid
  • Medicaid Buy-In
  • Medicaid Spend-Down
  • Medical Insurance
  • Medical Social Services
  • Medical Supplies
  • Medically Necessary
  • Medicare
  • Medicare Administrative Contractor (MAC)
  • Medicare Advantage
  • Medicare Advantage Disenrollment Period
  • Medicare Appeals Counsel (MAC)
  • Medicare Card
  • Medicare Fraud
  • Medicare Prescription Drug Benefit
  • Medicare Private Drug Plan
  • Medicare Private Health Plan
  • Medicare Savings Programs (MSP)
  • Medicare SELECT
  • Medicare Summary Notice (MSN)
  • Medicare-Approved Amount
  • Medicare-Certified
  • Medicare+Choice
  • Medigap
  • MSA (Medical Savings Account)
  • National Coverage Determination (NCD)
  • Network
  • Non-Participating Provider
  • Non-Preferred Provider/Care
  • Notice of Medicare Non-Coverage (NOMNC)
  • Notice of Medicare Provider Non-Coverage (NOMPNC)
  • Nursing Home
  • Observation Stay
  • Occupational Therapy
  • Off-Label
  • Opt-Out
  • Original Medicare
  • Out-of-Network
  • Out-of-Pocket Costs
  • Out-of-Pocket Limit
  • Outpatient
  • Outpatient Care
  • Outpatient Prospective Payment System (OPPS)
  • Over-the-Counter Drug
  • Palliative Care
  • Part A
  • Part B
  • Part C
  • Part D
  • Participating Provider
  • Pastoral Care
  • Patient Assistance Program
  • PDP (Prescription Drug Plan)
  • Personal Care
  • PFFS (Private Fee-for-Service)
  • Pharmacotherapy
  • Physical Therapy
  • Plan of Care
  • POS (Point-of-Service) Option
  • PPO (Preferred Provider Organization)
  • Pre-Approval
  • Pre-Authorization
  • Pre-Existing Condition
  • Preferred Provider/Care
  • Premium
  • Premium Penalty
  • Prescription
  • Prescription Drug
  • Prescription Drug Insurance
  • Preventive Care
  • Primary Care Physician (PCP)
  • Primary Insurance
  • Prior Authorization
  • Private Duty Nursing
  • Private Health Plan
  • Private Plan Card
  • Program of All-Inclusive Care for the Elderly (PACE)
  • Provider
  • PSO (Provider-Sponsored Organization)
  • QDWI (Qualified Disabled Working Individual)
  • QI (Qualifying Individual)
  • QIO Review
  • QMB (Qualified Medicare Beneficiary)
  • Qualified Independent Contractor (QIC)
  • Quality Improvement Organization (QIO)
  • Quantity Limit
  • Railroad Medicare Carrier
  • Railroad Retirement Board
  • Reconsideration
  • Red, White and Blue Card
  • Redetermination
  • Referral
  • Rehabilitative Care
  • Request for Reconsideration of Part B Premium Amount
  • Reserve Days
  • Respite Care
  • Retiree Insurance
  • Retroactive Disenrollment
  • Secondary Insurance
  • Semiprivate Room
  • Service Area
  • SHIP (State Health Insurance Assistance Program)
  • Skilled Care
  • Skilled Nursing Facility (SNF)
  • Skilled Nursing Services
  • Skilled Therapy Services
  • SLMB (Specified Low-Income Medicare Beneficiary Program)
  • SNP (Special Needs Plan)
  • Social Security Administration (SSA)
  • Special Election Period
  • Special Enrollment Period (SEP)
  • Specialist
  • Speech Therapy
  • Speech/Language Pathology
  • SSDI (Social Security Disability Insurance)
  • SSI (Supplementary Security Income)
  • State Pharmaceutical Assistance Program (SPAP)
  • Step Therapy
  • Supplemental Insurance
  • Supplier
  • Take Assignment
  • Temporary First Fill
  • Terminal Illness
  • Therapy Caps
  • Tiers
  • Transition Policy
  • TRICARE
  • TRICARE for Life
  • Unearned Income
  • Unskilled Care
  • Urgent Care
  • Utilization Management Tools
  • Veterans Administration (VA) Benefits
  • Waiting Period
  • Waiver of Liability
  • Work Credits
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