For Consumers
Glossary of Terms
Activities of Daily Living (ADL): The basic “work” involved in taking care of oneself, including bathing, dressing, eating, moving from a bed to a chair, getting to and from the toilet, and as being able to control the bowel and bladder.
ADL: The abbreviation for Activities of Daily Living. (See Activities of Daily Living.)
Case Manager: A healthcare professional, usually a nurse, social worker, gerontologist or psychologist, who specializes in helping individuals and families to plan for and organize long-term care services. The case manager develops a plan of care; assists, coordinates, and manages long-term care services; and monitors those long-term care needs over time.
Geriatric Case Manager: A case manager (see Case Manager) who specializes in elder care management.
Healthcare Inflation: Is the rate at which healthcare costs increase over time. Healthcare inflation is often presented and discussed in terms of an annual rate of healthcare cost increases. Healthcare inflation is not the same as and is usually much higher than general economic inflation, which is tracked and reported as the Consumer Price Index (CPI).
HDHP: The abbreviation for “high deductible health plan.” (See also High Deductible Health Plan.)
Health Reimbursement Arrangements (HRAs): Are IRS-sanctioned arrangements that allow an employer, as agreed to in the HRA plan document, to reimburse medical expenses paid by participating employees. HRAs reimburse only those items (co-payments, coinsurance, and deductibles) agreed to by the employer that are not covered by the company's selected standard insurance plan (any health insurance plan, not only high-deductible plans). These arrangements are described in IRS Section 105.
Health Savings Account (HSA): Is a tax-advantaged medical savings account available for individuals enrolled in a High Deductible Health Plan (HDHP). The funds contributed to the account are not subject to federal income tax at the time of deposit. Funds may be used to pay for qualified medical expenses at any time without federal tax liability. Withdrawals for non-medical expenses are treated very similarly to those in an IRA account in that they may provide tax advantages if taken after retirement age, but they incur penalties if taken earlier. HSA's do not have to be spent in their entirety during the year. Leftover funds can stay in the account and be rolled over for future use.
High Deductible Health Plan (HDHP): Is a health insurance plan with lower premiums and higher deductibles than a traditional health plan. It is sometimes referred to as a “catastrophic health insurance plan” or a “consumer-driven health plan.” In order to qualify as a HDHP, the plan is required by the IRS to meet standard amounts for the deductibles. In 2008 those requirements are $1,100 for a minimum single deductible, $2,200 for a minimum family deductible, with a $5,600 maximum single out-of-pocket costs and an $11,200 maximum for family out-of-pocket costs.
HRA: The abbreviation for “health reimbursement arrangements.” (See also Health Reimbursement Arrangements.)
HSA: The abbreviation for Health Savings Account. (See Health Savings Account.)
Instrumental Activities of Daily Living (IADL): The range of activities necessary to live independently in the community, such as cooking, grocery shopping, managing finances, managing healthcare appointments and arrangements, managing personal safety and transportation, and housework.
IADL: The abbreviation for the Instrumental Activities of Daily Living. (See Instrumental Activities of Daily Living.)
MA: The abbreviation for Medicare Advantage also known as Medicare Part C. (See Medicare Part C.)
MA+D: The abbreviation for Medicare Advantage (or Medicare Part C) plus Medicare Part D. (See Medicare Advantage plus D.)
Medical Flexible Spending Accounts (Medical FSAs): Tax-advantaged financial accounts that can be set up through an employer’s “cafeteria plan.” A Medical FSA allows an employee to set aside a portion of earnings to pay for qualified medical expenses, as specified in the cafeteria plan. Money deducted from an employee's pay into an FSA is not subject to payroll taxes, which results in substantial payroll tax savings. Funds in Medical FSAs must be used completely within a designated year. Unused funds will be forfeited by the individual.
Medicaid: A health insurance program for certain low-income individuals and families, of any age, who meet the criteria, which are set by federal and state governments. Medicaid health insurance is paid for by tax dollars from federal, state and sometimes local budgets. Medicaid coverage varies widely around the Untied States, based primarily on state and local regulations.
Medical Savings Account (MSA): Is an account, generally associated with self-employed individuals, in which tax-deferred deposits can be made for medical expenses. Withdrawals from the MSA are tax-free if they’re used to pay for qualified medical expenses. The MSA must be coupled with a high-deductible health plan (HDHP). Withdrawals from an MSA go toward paying deductibles and other expenses in a given year. MSA funds can cover expenses related to most forms of medical care, disability, dental care, vision care and long-term care, whether the expenses were billed through the qualifying insurance or otherwise. If there are funds remaining in the MSA at the end of the year, the funds can either roll over for the following year or can be withdrawn as taxable income. MSAs are somewhat different from Health Savings Accounts (HSAs), which have become the more widely available form of these accounts.
Medicare: The federally administered health insurance plan that covers all United States Social Security recipients. This includes people who are eligible for Social Security who are 65 years of age or older, and those who are younger than 65 years of age but are medically disabled. The Medicare health insurance program is administered by the US government’s Centers for Medicare and Medicaid. Medicare benefits are paid for by payroll taxes, general tax revenues and beneficiary premiums. In addition, beneficiaries are responsible for paying part of the cost for most care. Out-of-pocket costs include deductibles, co-payments and premiums for some “parts” of Medicare.
Medicare Advantage (MA): Is Medicare Part C. (See Medicare Part C).
Medicare Advantage plus D (MA+D): Is Medicare Advantage (or Medicare Part C) plus Medicare Part D to cover some pharmaceuticals.
Medicare Part A: The part of Medicare health insurance that covers acute-care as well as short-term care in skilled nursing facilities for rehabilitation, short-term skilled home care and hospice services. Part A is automatically covered under Medicare.
Medicare Part B: Also known as “Medicare Supplemental.” It covers outpatient medical visits and other services, such as laboratory and diagnostic testing. Part B is optional Medicare coverage
Medicare Part C: A health maintenance organization (HMO) type of coverage that is also known as “Medicare Advantage” (MA), which is a combination of Medicare Parts A and B. Sometimes Medicare Part C also includes Medicare Part D and is known as Medicare Advantage with Prescription Drug coverage (MA-PD).
Medicare Part D: Medicare health insurance that covers many prescription drugs at various levels of payment. Medicare Part D is optional Medicare coverage that you pay for out of pocket.
Medicare Supplemental: Another name for Medicare Part B (See Medicare Part B.)
Medigap: Health insurance you can purchase to cover the “gaps” in your Medicare coverage, including co-payments and deductibles that are built into the Medicare program. Medigap insurance is sold by private insurance companies to individuals and is not a required “part” of Medicare. There are up to 12 varieties of Medigap plans, labeled A through L. Not all varieties of Medigap insurance are available in all areas, due to state laws that govern health insurance.
MSA: The abbreviation for Medical Savings Account. (See Medical Savings Accounts.)
Nurse Practitioner (NP): A registered nurse (RN) with advanced training, usually a master’s or doctoral degree, who can diagnose and treat illness. Nurse practitioners prescribe medications, treat illnesses and perform physical exams. NPs differ from physicians in that they have a greater focus on prevention, wellness and patient/family education. Many NPs specialize in particular areas of healthcare.
Over-the-Counter Drugs (OTCs): Medications that are available at drug stores and other retail stores without a prescription.
Respite Care: Supportive service that gives caregivers, such as family and friends, temporary relief from the responsibility of caring for family members who are unable to care for themselves. Respite care is provided in a variety of settings, including in a patient’s home, at adult day centers and in nursing homes.