Glossary
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
C
Case Management:
A process used by a doctor, nurse, or other health professional to manage
health care. Case managers make sure you get needed services and track
your use of facilities and resources.
Source:
Centers for Medicare & Medicaid
Services
Catastrophically Disabled:
Catastrophically
disabled persons have a permanent severely disabling injury, disorder
or disease that compromises the ability to carry out the activities
of daily living to such a degree that the individual requires personal
or mechanical assistance to leave home or bed or requires constant
supervision to avoid physical harm to self or others.
Source: The U.S. Department of Veterans
Affairs
Categorically Needy:
As defined by the Centers for Medicare & Medicaid
Services, categorically needy individuals are
those who must be covered, which usually includes:
low-income families with children; individuals
receiving Supplemental Security Income (SSI);
pregnant women, infants and children with incomes
less than a specified percent of the Federal poverty
level; and qualified Medicare beneficiaries.
States have options as to how they define categorically
needy. Their definition may include individuals receiving only a state
supplementation of SSI, although their income would prohibit any SSI
payment. Categorically needy individuals must be provided with the
following services: inpatient hospital services; outpatient hospital
services; rural health clinic services; laboratory and x-ray services;
nursing facility services; home health care services for individuals
age 21 or older; family planning services and supplies; early and periodic
screening, diagnosis and treatment for individuals under age 21; certified
mid-wife services and physician services; certified pediatric and family
nurse practitioner services; and Federally qualified ambulatory and
health center services. In addition, there are many other services
a state may choose to provide such as prescription drugs. For the medically
needy, states have considerably more discretion in the services they
provide.
Source: Social Security Administration (SSA)
Centers for Medicare & Medicaid
Services (CMS):
The Centers for Medicare & Medicaid
Services (CMS) is a Federal agency within the U.S. Department of Health
and Human Services. CMS runs the Medicare and Medicaid programs - two
national health care programs that benefit about 75 million Americans.
And with the Health Resources and Services Administration, CMS runs
the State Children's Health Insurance Program (SCHIP).
Source:
Centers for Medicare & Medicaid
Services
Child:
Under Social
Security, a recipient’s "child" refers to a biological
child or any other child who can inherit personal property under state
law, or who meets certain specific requirements under the Social Security
Act. This can include a legally adopted child, equitably adopted child,
stepchild, or grandchild.
Source: Social Security Administration
Claim:
A claim is a
request for payment for services and benefits received.
Source:
Centers for Medicare & Medicaid
Services
Compensable:
Able to
be compensated or paid.
Source: Merriam-Webster Dictionary, 2003
Conditional Entry/Resident (under immigrant law):
Any
alien granted permanent resident status on a conditional basis (e.g.,
a spouse of a U.S. citizen; an immigrant investor), who is required
to petition for the removal of the set conditions before the second
anniversary of the approval of his or her conditional status.
Source: U. S. Citizenship and Immigration Services (USCIS)
Continuing Disability Review (CDR):
Federal
law requires Social Security to do a Continuing Disability Review (CDR)
on any disabled child to determine whether or not the child remains
disabled. The CDR must be done at least every three years for recipients
under age 18 whose condition is likely to improve, and no later than
12 months after birth for babies whose disability is based on low birth
weight. Social Security may also do CDRs for recipients under age 18
whose conditions are not likely to improve. At the time a CDR is conducted
the representative payee must present evidence that the child is and
has been receiving treatment considered medically necessary and available
for his or her disabling condition. Failure to provide this evidence
may result in suspended payment of benefits.
Source: Social Security Administration
Continuum of Care (CoC):
A
Continuum of Care is a local or regional system for helping people
who are homeless or at imminent risk of homelessness by providing housing
and services appropriate to the whole range of homeless needs in the
community, from homeless prevention to emergency shelter to permanent
housing. In 1995, the Department of Housing and Urban Development (HUD)
implemented the Continuum of Care approach to streamline the existing
competitive funding and grant-making process under the McKinney-Vento
Homeless Assistance Act and to encourage communities to coordinate
more fully the planning and provision of housing and services for homeless
people.
Source: The Department of Housing and
Urban Development
Copayment:
In some
health plans, a copayment is the amount paid for each medical service,
like a doctor's visit. A copayment is usually a set amount. For example,
this could be $5 or $10 for a doctor's visit.
Source:
Centers for Medicare & Medicaid
Services
Credits:
Previously
called "Quarters of Coverage." As an individual works and
pays taxes, he or she earns credits that count toward eligibility for
future Social Security benefits. An individual can earn a maximum of
four credits each year. Most people need 40 credits to qualify for
benefits. Younger people need fewer credits to qualify for disability
or survivors benefits.
Source: Social Security Administration
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