Glossary of Medical Terms
This is a list of medical and healthcare terms that are used on this site.
ACOs are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated care to their Medicare patients.
Personal care activities an individual needs to perform to live independently, such as eating, bathing, dressing, toileting, and getting in and out of bed and chairs.
- Medical problem with rapid or new onset.
- Short-term medical treatment, usually in a hospital, for patients having an acute illness or injury or recovering from surgery.
The time of year when most people can choose to elect or change their Medicare plan options. The annual election period runs from October 15th through December 7th annually.
Traditional exercises, done in a pool, that use the natural buoyancy of water to accelerate the rehabilitation process
Specializing in the treatment of obesity with a Body Mass Index of 40 or more.
The way that Original Medicare measures your use of hospital and skilled nursing facility (SNF) services. A benefit period begins the day you're admitted as an inpatient in a hospital or SNF. The benefit period ends when you haven't gotten any inpatient hospital care (or skilled care in a SNF) for 60 days in a row. If you go into a hospital or a SNF after one benefit period has ended, a new benefit period begins. You must pay the inpatient hospital deductible for each benefit period. There's no limit to the number of benefit periods.
Bi-level positive airway pressure that is a non-invasive form of therapy that assists in breathing and keeps the airway open and the lungs inflated. It uses a timed cycled, or flow cycled change between two-level positive airway pressure that goes up and down with each breath. It is sent through a tube into a mask, that fits over the nose or tracheostomy. It delivers an inhale pressure and exhale pressure and is often used when CPap is not tolerated.
A system that tracks patients over time through an array of health services that spans all levels and intensity of care.
Deliberately organizing patient care activities and sharing information among all participants concerned with patients care.
A list of providers that can include physician, nurse, pharmacist, therapists, and social worker. Should also include the patient or caregiver.
Flexible plastic tube, inserted through the chest wall that acts as a drain for blood, fluid, or air from around your lungs, heart, or esophagus.
Chronic indicates indefinite duration or virtually no change.
An amount you may be required to pay as your share of the cost of services after you pay any deductibles. Coinsurance is usually a percentage (for example 20%).
A nonprofit accreditor of health and human services.
With only Medicare Part A and Part B, you are still responsible for at least 20% coinsurance and the $1288 deductible. Medicare does not have a "Maximum Out of Pocket" cost that caps how much you will pay in a given year.
A treatment that uses mild air pressure in your throat so your airway does not collapse when you breathe in.
Custodial care is non-skilled personal care, such as help with activities of daily living (ADLs) like bathing, dressing, eating, getting in or out of bed, moving around, and using the bathroom.
The amount you must pay for health care or prescriptions before Medicare, prescription drug plan, or other insurance begins to pay.
Expert on diet and nutrition.
A nasal duodenal feeding tube. A flexible, silicone tube that is inserted into the nose that has a weighted tip to help it pass through the digestive tract to serve as an alternative form of nutrition.
An in person doctor visit.
Surgical procedure where tissue is transferred from one donor site to another while maintaining its own blood supply.
The surgical procedure to move tissue from one site to another on the body.
Form of respiratory support used in the hospital where oxygen, often used in conjunction with compression and humidification, is delivered to someone at rates of flow higher than that delivered in traditional oxygen therapy.
For Home Health Services, a person needs to be confined to home or absences must be infrequent or of short duration, such as religious services, adult day care programs, or other unique or infrequent events like weddings, funerals, etc.
A setting where you stay overnight to receive healthcare services.
For the purposes of healthcare, an institution is a facility that provides short term or long term care, like a skilled nursing facility (SNF), inpatient hospital, or rehabilitation hospital.
Not happening steadily or continuously; stopping and starting repeatedly.
An organization that accredits healthcare facilities and their programs to.
Additional days that Medicare Part A will pay for when a beneficiary is in a hospital for more than 90 days during a benefit period. Beneficiaries are limited to a total of 60 reserve days over the course of their life.
Type of insurance developed specifically to cover nursing homes, assisted living, private duty, and other long term care services that are traditionally not covered by health insurance plans or Medicare.
State funded health insurance program for those who qualify as low income.
Standard used by insurance companies to determine if treatment and services are appropriate for a patients heath care needs. Frequently a health plan will include a list of requirements that will need to be met in order to approve coverage.
(Medicare Part C) Also called Medicare Replacement Plan. With these plans, a private company contracts with Medicare to provide all of your Part A and Part B benefits. If you're enrolled in a Medicare Advantage plan, most Medicare services are covered through the plan and are not paid for under Original Medicare. Most Medicare Advantage plans offer prescription drug coverage.
Also called Medicare Replacement Plan. With these plans, a private company contracts with Medicare to provide all of your Part A and Part B benefits. If you're enrolled in a Medicare Advantage plan, most Medicare services are covered through the plan and are not paid for under Original Medicare. Most Medicare Advantage plans offer prescription drug coverage.
Covers hospitals, skilled nursing facilities, home health, and hospice. No monthly cost for those who qualify, with $1,316 deductible per 60 day benefit period.
Covers doctors' visits, other outpatient services such as surgeries, and medical equipment and supplies. Med B covers 80% of all outpatient medical costs.
(Medicare Advantage) Also called Medicare Replacement Plan. With these plans, a private company contracts with Medicare to provide all of your Part A and Part B benefits. If you're enrolled in a Medicare Advantage plan, most Medicare services are covered through the plan and are not paid for under Original Medicare. Most Medicare Advantage plans offer prescription drug coverage.
Covers prescription drugs. Average monthly cost is $34.10, and any additional copays, coinsurances, or deductibles depends on plan selection.
(Medigap) You can purchase a Medicare Supplement Insurance policy, sometimes called Medigap, to help pay some of the health care costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles.
(Medicare Supplement) You can purchase a Medicare Supplement Insurance policy, sometimes called Medigap, to help pay some of the health care costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles.
Conditions that can affect your muscles, bones, and joints
A tube passed into the stomach via the nose. It is used for short or medium term nutritional support and also aspiration of stomach contents.
Occupational Therapy is therapeutic rehabilitation based on the engagement in activities of daily living (ADLs) to promote the recovery and restoration of skills after illness, injury, or disease. Occupational Therapists utilize a variety of skilled interventions to improve coordination, strength, endurance, visual perceptual skills, range of motion, balance and mobility related to ADL performance. OTs also assess positioning needs and provide patient/family education.
A doctor specializing in rehabilitation.
Physical Therapy is rehab concerned with the restoration of functional, as well as the prevention of physical disability, following disease, injury, or illness. Physical Therapists utilize a variety of skilled interventions to improve balance, mobility, gait, posture, endurance, and strength, educate on assistive devices, provide patient/family education, and decrease the risk of falls.
Post-acute care includes rehabilitation or palliative services that you receive after, or in some cases instead of, a stay in an acute care hospital. Depending on the intensity of care required, treatment may include a stay in a facility, ongoing outpatient therapy, or care provided at home.
A request by your provider to have a particular service or treatment approved by your insurance company.
The periodic payment to Medicare, insurance, or healthcare plan for health or prescription drug coverage.
The insurance that pays first is the primary payor. Primary insurance pays up to the limits of its coverage.
Medical doctors who evaluate patients to determine whether their symptoms are the result of a physical illness, a combination of physical and mental ailments, or strictly psychiatric.
A professional who evaluates and studies behavior and mental processes.
A written request for information or consideration for care.
Restoring someone to health or normal life through training and therapy after an illness.
When not enough oxygen passes from your lungs into your blood.
A specialized healthcare practitioner who is trained in pulmonary medicine, in order to work with people suffering from a respiratory condition.
A very short inpatient stay for a hospice patient so the usual caregiver can rest. Medicare will pay for up to 5 days of respite care, covering room and board, if you're currently getting covered hospice care.
The insurance that pays second only pays if there are costs the primary insurer didn't cover. The secondary payer (which may be Medicare) may not pay all the uncovered costs.
Speech therapy is the treatment of speech, communication and/or swallowing disorders. The approach used varies depending on the disorder. Speech Therapists may utilize physical exercises to strengthen the muscles used in speech/swallowing (oral-motor work), speaking exercises to improve clarity, or sound production practice to improve articulation.
Less intense level of care or therapy where patients are stable and no longer require acute level hospital care.
Also known as Gap Insurance.
Therapy caps for 2017 is $1,980 for PT and SLP services combined. Therapy cap is $1,984 OT services.
Total Parental Nutrition is the feeding of a person via IV that bypasses the usual process of eating and digestion, and supplies all daily nutritional needs.
A stoma or hole in your trachea, or wind pipe, that serves as an airway that allows a person to breathe without the use of the nose or mouth.
The movement of a patient from one healthcare setting to another.
Physicians, physical therapists, nurses, respiratory therapists, pharmacists, dietitians, and case managers.
A mechanical machine designed to move breathable air into and out of the lungs to provide breathing for someone who is physically unable to breath or breathing insufficiently. Sometimes called respirators.
A form of therapy designed to help patients with issues of dizziness, vertigo, balance disorders.
Provides funds to people who are injured at work.
Process of removing dead tissue from a wound to promote healing.