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A doctor, hospital, or other health care provider that agrees to accept the medical plan’s terms and conditions related to payment rendered for health care services.
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Any person identified with health care insurance via the Medicare or Medicaid program.
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Non-skilled caretakers who help with daily activities such as bathing, dressing, eating, getting in out of a bed or chair, moving around and using the bathroom. Such home health service is not covered by most medical plans.
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Medical equipment available for home health care purposes, such as walkers, wheelchairs, hospital beds, and oxygen tanks.
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Any list of drugs covered in a medical plan.
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Group Health Plans provide coverage to employees, former employees, and their families. It is usually provided by an employer or employee organization.
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A Medicare Advantage Plan that is only available in certain areas of the country.
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Nursing care and home health assistance that aid in physical therapy, occupational therapy, speech-language pathology, medical social services, durable medical equipment, medical supplies, and other services.
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A philosophy based style of care, focused on the quality of a patient’s life.
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Health care received when admitted to a hospital or skilled nursing facility.
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Any type of health care that tends to a patient’s personal needs and activities over an extended period of time, such as custodial care. Typically provided at home or an assisted living facility.
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A federal and state program that helps alleviate financial problems related to medical costs.
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Any medical service or supply that is required to treat or diagnose a patient.
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A federal insurance program providing health insurance coverage for people aged 65 years or older.
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Drugs that are not approved by a medical plan.
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Medical or surgical care provided by a hospital for a patient who does not stay overnight.
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Any service provided by a licensed physician.
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An employer or employee organization that maintains an employee benefit plan, including a group health care plan.
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A health problem a patient has suffered prior to the start of a new insurance policy.
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The periodic payment to Medicare, an insurance company, or a health care plan for health care or prescription drug coverage.
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Health care to keep you healthy or to prevent illness (for example, Pap tests, pelvic exams, flu shots, and screening mammograms)
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Quality is how well the health plan keeps its members healthy or treats them when they are sick. Good quality health care means doing the right thing at the right time, in the right way, for the right person—and getting the best possible results.
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A written order from your primary care doctor for you to see a specialist or get certain services.
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Rehabilitative services are ordered by your doctor to help you recover from an illness or injury. These services are given by nurses and physical, occupational, and speech therapists. Examples include working with a physical therapist to help you walk and with an occupational therapist to help you get dressed.
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The way payments and health plans are changed to take into account a person's health history.
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