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| Health Care Terms |
Adult living community: A housing
and living arrangement that provides the shelter of a home along with additional
services, ranging from housekeeping to health care services. Adult living
communities are also known as retirement communities, continuing care facilities,
and assisted living facilities.
Copayment: A cost-sharing arrangement
under which the insurance company insures only part of the potential loss,
and the policy owners pay the other part.
Custodial care: Level of health
or medical care given to meet daily personal needs, such as dressing, bathing,
getting out of bed, etc. Although custodial care does not need to be provided
by trained health care professionals, it must be administered under a physician's
order.
Deductible: A specified amount
of expense to be paid by the insured before a health insurance policy starts
paying benefits.
Durable power of attorney: A written
document whereby the individual executing the power of attorney (the principal)
authorizes another (the agent, attorney-in-fact, or proxy) to act on their
behalf to manage the principal's financial affairs. The durable power of
attorney survives the incapacity of the principal.
Durable power of attorney for health care: A written
document allowing an individual (the principal), when
competent, to authorize one or more individuals (the agents) to make
decisions about medical treatment and care in the event of incapacity of
the principal.
Fee-for-service: A payment system
by which physicians, hospitals and other providers are paid a specific
amount for each service performed as it is rendered and identified by a
claim for payment.
Health Maintenance Organization (HMO): A managed care plan that
both finances health care services for its
subscribers on a prepayment basis and organizes and provides health care
services directly through its own employed or contracted health care providers.
Home health care: Skilled or unskilled
care provided in an individual's home, usually on a part-time basis.
Informed consent: A
legal concept requiring full disclosure to the patient of the nature and
consequences of proposed medical tests and treatments and obtaining the
patient's consent. Informed consent requires disclosure of the diagnosis,
potential risks and benefits of the proposed medical treatment or procedure,
and the benefits and limitations of available treatment alternatives.
Living will: A type of advance
directive allowing individuals, while competent, to express whether or
not they wish to receive or decline/ continue or discontinue medical treatment
and procedures when they become incompetent, and either terminally ill
or in a persistent vegetative state.
Long-term care: Refers to the broad
range of medical and personal services for individuals who need assistance
with daily activities for an extended period of time.
Long-term care insurance: An insurance
policy designed to provide coverage for long-term care expenses that are
not covered by general insurance plans or by government programs.
Medical Savings Account (MSA):
A trust created to pay the qualified medical expenses of the person for
whom the trust was created. MSAs may be available to small business employees
and self-employed persons who are insured under a high deductible health
plan. Eligible employees and their employers contribute certain amounts
to the MSA and receive favorable tax treatment. Account balances can be
used to cover qualified medical expenses.
Nursing home: A type of long-term
care facility providing professional medical care on a 24-hour basis. Nursing
homes provide different levels of care, including skilled, intermediate
and custodial care.
Preferred Provider Organization (PPO): A health care delivery system that
contracts with providers of medical
care to provide services at discounted fees to members. Members may seek
care from nonparticipating providers, but generally are financially penalized
for doing so by the loss of the discount and subjection to copayments
and deductibles.
Provider Sponsored Organization (PSO): PSOs are similar to PPOs
except that they are operated by a group of physicians and hospitals.
Reverse mortgage: A financial planning
tool available to the elderly who are "house rich and income poor" allowing
them to remain in their homes as long as possible by allowing homeowners
to convert the equity in their principal residence into cash without selling
their home.
Rider: Any supplemental agreement
attached to, and made part of, an insurance policy that modifies the conditions
of the policy by expanding or restricting its benefits or excluding certain
conditions from coverage. |
