Home Health Care Glossary

This glossary is to help our home health care community better understand the terms used in relation to care. Please book mark this page for future reference or download our printable version HERE.

Managed Care Any form of health benefits plan that actively monitors health care services received by covered individuals for effectiveness, cost efficiency, or quality. Typically, managed care plans provide a higher level of benefits for a select network of contracted providers, and may require preauthorization of certain services.
Mandate Law requiring that a health plan or insurance carrier offers a particular procedure or type of coverage.
Medicaid A state government program that provides health care insurance and medical assistance to people, including families and children, who meet income eligibility requirements.
Medical IRAs Personal accounts, like individual retirement plans, that allow a person to accumulate funds for future health care purposes.
Medical social work (MSW) Medical social work services deal with the social, psychological, and economic needs of individuals and how to address them in the home environment.
Medical supplies Essential items that the home health team uses to conduct home visits or carry out services the physician has order to treat or diagnose a patient’s illness or injury.
Medically necessary Services or supplies that are needed for the diagnosis or treatment of a medical condition and meet accepted standards of medical practice.
Medicare The largest payor of home health care services, this federally mandated program sets the standards for many other insurers. Medicare provides health care coverage for persons age 65 and older, persons who are defined for social security purposes as "disabled" for at least two years, and certain other special cases. Some individuals who are age 65 or older may not be covered if they have not contributed to Social Security for a minimum number of quarters. Medicare part "A" (hospital insurance) coverage is provided to eligible individuals at no cost, and covers hospitalization, some inpatient care in a skilled nursing facility, home health, and hospice care. Medicare part "B" (medical insurance) coverage is optional, a premium is charged to beneficiaries who desire it, and it covers physician services, outpatient hospital services, durable medical equipment, and a number of other supplies and services not covered by Medicare part "A."
Medicare Advantage Plan (also called Medicare Part C) This Medicare program gives you more choices among health plans and extends benefits beyond the Original Medicare plan. It includes private Medicare Advantage plans (such as HMOs and PPOs) that provide Part A and B benefits to enrollees, as well as Medicare prescription drug benefits beginning in 2006. Nearly everyone with Medicare Parts A and B is eligible for a Medicare Advantage plan. Medicare Advantage plans previously were called Medicare+Choice plans.
Medicare Part A This government-supported health insurance plan helps cover inpatient hospital care, care in nursing homes, hospice care, and some home health care for qualified Americans age 65 and older and certain younger individuals with disabilities. Most people pay for Part A coverage through taxes while working and therefore do not pay a deductible or monthly premium.
Medicare Part B This government-supported insurance plan covers doctors' services, outpatient hospital care, medical equipment, physical and occupational therapy, and some home health care for qualified Americans age 65 and older and certain younger individuals with disabilities. Most people pay an annual deductible and a monthly premium for this health plan.
Member A person enrolled in a health care plan.