20 Terms
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Medicare & Medicaid
Medical insurance programs administered by the U.S. federal government that provide health care coverage for the elderly (people over 65) and certain people and families with low incomes and resources.
Industry: Insurance
Add a new termContributors in Medicare & Medicaid
Medicare & Medicaid
Qualified medicare beneficiary (QMB)
Insurance; Medicare & Medicaid
This is a Medicaid programme for beneficiaries who need help in paying for Medicare services. The beneficiary must have Medicare Part A and limited income and resources. For those who qualify, the ...
Organisational determination
Insurance; Medicare & Medicaid
A health plan's decision on whether to pay all or part of a bill, or to give medical services, after you file an appeal. If the decision is not in your favor, the plan must give you a written notice. ...
Intermediate entities
Insurance; Medicare & Medicaid
These are entities, which contract between an MCO or one of its subcontractors and a physician or physician group, other than physician groups themselves. An IPA is considered to be an intermediate ...
Programmes of all-inclusive care for the elderly (pace)
Insurance; Medicare & Medicaid
PACE combines medical, social, and long-term care services for frail people. PACE is available only in states that have chosen to offer it under Medicaid. To be eligible, you must: * Be 55 years old, ...
Private fee-for-service plan
Insurance; Medicare & Medicaid
A type of Medicare Advantage Plan in which you may go to any Medicare-approved doctor or hospital that accepts the plan?s payment. The insurance plan, rather than the Medicare program, decides how ...
Physician group
Insurance; Medicare & Medicaid
A partnership, association, corporation, individual practise association (IPA), or other group that distributes income from the practise among members. An IPA is considered to be a physician group ...
Federally qualified health centre (FQHC)
Insurance; Medicare & Medicaid
Health centres that have been approved by the government for a programme to give low cost health care. Medicare pays for some health services in FQHCs that are not usually covered, like preventive ...
