Medicare Glossary

Fee for Service or FFS meaning in Healthcare

Key characteristics of the fee-for-service model include:

General Medicare CMS Glossary of terms you should know.

Medicare and Medicaid. Here are some key terms from the CMS glossary:

Group health plan

Some common types of group health plans include:

Guaranteed issue rights and Medigap protections

Guaranteed issue rights in relation to Medigap, refer to the legal protections provided to individuals.

Guaranteed renewable policy

Since 1992, Medigap or Supplement policies are guaranteed renewable.

Health Insurance and Cafeteria Plans.

A Cafeteria Plan, also known as a Section 125 plan, is a type of employee benefit plan.

Health Insurance Marketplace

The Health Insurance Marketplace is a service that assists people in finding and enrolling in affordable health insurance.

Health Insurance Permission to Contact the Consumer form

Per Federal law, Health Insurance Agents are required the Consumer sign both Permission to Contact and Scope of Appointment before discussing health insurance.

Health Risk Assessment

Health Risk Assessments allow Medicare Advantage carriers to understand the needs of the member, prompting the Carrier to coordinate the appropriate resources.

Healthcare providers

Medicare doesn't directly provide healthcare, but works with hospitals, physicians, drug manufacturers to cover eligible medical services and items.

HMO Physician Referral

A formal request by your physician for you to see a specialist or receive specific medical services in writing from your primary care physician.

HMO-Health Maintenance Organization

Here are key characteristics and features of HMOs:

How does State Pharmaceutical Assistance Program (SPAP) help Medicare?

State Pharmaceutical Assistance Program (SPAPs) provide a range of assistance to Medicare beneficiaries, including:

Income-Related Monthly Adjustment Amount (IRMAA)

IRMAA affects Medicare Part D:

Insurance concept of Adverse Selection regarding Medicare or Medicaid.

Adverse Selection is not a discriminatory part of Medicare or Medicaid Actuarial calculations since all US Citizens of a certain Age or disability are eligible.