Inpatient Care
What is Inpatient Care? Inpatient care is medical care provided in a hospital or other inpatient facility. Inpatients are admitted and stay at least one…
Topic: Glossary
Prior Authorization
What is Prior Authorization in Medicare Advantage? Prior authorization is a process used by health plans to control healthcare costs. Most Health Maintenance Organization (HMO)…
Pre-Existing Condition
What are Pre-Existing Conditions? A pre-existing condition is any health problem before enrolling in a health plan. The Affordable Care Act law made it illegal…
Medicare Part C
What is Medicare Part C? Medicare Part C is Medicare’s private health insurance option for people with both Medicare Part A and Part B benefits.…
MA-PD
What is a Medicare Advantage Prescription Drug Plan? A Medicare Advantage plan that offers Medicare prescription drug coverage (Part D), Part A, and Part B…
Medically Necessary
What is a Medically Necessary Mean in Medicare? Services or supplies are needed to diagnose or treat your medical condition and meet accepted standards of…
Medical Emergency
What is a Medical Emergency? When you believe you have an injury or illness that requires immediate medical attention to prevent a disability or death.
Long-Term Care
What is Long-Term Care? Long-term care refers to a variety of services that help people with their medical and non-medical needs over a period of…
Limiting Charge
What is a Limiting Charge in Medicare? In Original Medicare, the highest amount of money you can be charged for a covered service by doctors…
In-Network
What is an In-Network Provider? Doctors, hospitals, pharmacies, and other healthcare providers that agree to health plan members’ services and supplies at a set price…