Medicare & Medicaid

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

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Medicare & Medicaid

SEER - Medicare database

Insurance; Medicare & Medicaid

Consists of a linkage of the clinical data collected by the SEER registries with claims for health services collected by Medicare for its beneficiaries.

Anaesthesia

Insurance; Medicare & Medicaid

Drugs that a person is given before surgery so he or she will not feel pain. anaesthesia should always be given by a doctor or a specially trained nurse.

Full capitation

Insurance; Medicare & Medicaid

The plan or Primary Care Case Manager is paid for providing services to enrollees through a combination of capitation and fee for service reimbursements.

Actual charge

Insurance; Medicare & Medicaid

The amount of money a doctor or supplier charges for a certain medical service or supply. This amount is often more than the amount Medicare approves.

Group health plan

Insurance; Medicare & Medicaid

A health plan that provides health coverage to employees, former employees, and their families, and is supported by an employer or employee organization.

Gapfilling

Insurance; Medicare & Medicaid

Used when no comparable, existing test is available. Carrier specific amounts are used to establish a national limitation amount for the following year.

Specialist

Insurance; Medicare & Medicaid

A doctor who treats only certain parts of the body, certain health problems, or certain age groups. For example, some doctors treat only heart problems.