Glossary of Healthcare Terms

Coinsurance

A form of medical cost sharing in a health insurance plan that requires an insured person to pay a stated percentage (rather than a set dollar amount) of medical expenses after the deductible amount, if any, was paid.

Grievance

A complaint an insured communicates to his or her health insurer or plan.

Medicare Part A

Hospital insurance that helps cover inpatient care in hospitals, skilled nursing facilities, hospice and home care. Most beneficiaries are enrolled in Part A automatically.

Medicare Part B

Medical coverage that helps to cover medically necessary services like doctors’ services, outpatient care, home health services and other medical services. Part B also covers some preventive services, and physician-administered drugs like immunoglobulin replacement therapy for patients with most kinds of primary immunodeficiency diseases. Most beneficiaries are enrolled in Part B automatically.

Medicare Part C/Medicare Advantage (MA)

A type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Medicare Part A and Part B benefits. There are many types of Medicare Advantage Plans (MAP) include HMOs, PPOS, Private Fee-for-Service Plans, Special Needs Plans and Medicare Medical Savings Account Plans. If you are enrolled in an MA plan, Medicare services are covered through the plan and are not paid for under Parts A and B Most Medicare Advantage Plans offer prescription drug coverage.

Medicare Part D

An optional program that provides prescription drug coverage. There are two ways to get Medicare prescription drug coverage: through a Medicare Prescription Drug Plan or a Medicare Advantage Plan thatincludes drug coverage. These plans are offered by insurance companies and other private companies approved by Medicare.