ehealthmedicare.com

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Definitions (222)

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STATE INSURANCE DEPARTMENT


A state agency that regulates insurance rules and regulations and can provide information about private insurance plans, such as Medigap.
Source: ehealthmedicare.com

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actuarial equivalent


A plan sponsor's prescription drug plan that is at least equal to or better in terms of benefits when compared to a Medicare Part D Prescription Drug Plan.
Source: ehealthmedicare.com

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any willing provider


A doctor, hospital, or other health care provider that agrees to accept the health service plan's terms and conditions with regards to payment and that meets other requirements for coverage. The physicians and doctors who enroll as "any willing provider" agree to the plan's terms with regard to patient care and fee [..]
Source: ehealthmedicare.com

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Accreditation


A process by which an accredited certification body assesses and reviews the quality of the health care organization's policies, procedures, and performance based on established standards. Accreditation bodies themselves are evaluated and overseen by the International Accreditation Forum (IAF).
Source: ehealthmedicare.com

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ADVANCE BENEFICIARY NOTICE


A notice given by a health care provider, doctor, or supplier gives to a Medicare beneficiary before providing a service or furnishing a product for which Medicare may deny payment. In such a case, if you aren't given an ABN before you receive the service or product and Medicare denies payment, you may not have to pay for that service or pr [..]
Source: ehealthmedicare.com

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Advance coverage decision


A preliminary determination of Private Fee-For-Service plan, such as Medicare Advantage (Medicare Part C), about whether or not Medicare will pay for a certain service. This is unrelated to the Advance Beneficiary Notice (ABN), which only applies to people with Original Medicare, Part A and Part B.
Source: ehealthmedicare.com

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advance directive


Written individual instructions, which may include a living will or a power of attorney, for health care and for medical decisions to be made if the individual is not capable of making them himself/herself.
Source: ehealthmedicare.com

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ALS


ALS stands for amyotrophic lateral aclerosis, which is a degenerative disease that affects nerve cells in the spinal cord and brain and results in severe muscular weakness and atrophy. ALS is also called Lou Gehrig's disease, in reference to the New York Yankees baseball player who died from the disease.
Source: ehealthmedicare.com

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Ambulatory surgical center


A public or private licensed facility established to perform medical procedures or surgeries that do not require patients to stay overnight in a hospital or health care center.
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Angina pectoris


A health condition characterized by severe chest pain caused by insufficient blood flow to the heart. The pain often spreads to the neck, shoulders, and arms.
Source: ehealthmedicare.com


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