A federal health insurance program for people 65 and older and certain younger people with disabilities. It also covers people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).
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- Glossary: Centers for Medicare and Medicaid Services [CMS]Centers for Medicare and Medicaid Services, a federally funded program that provides funding to states for individuals that meet the income and level of care requirements for the Affordable Care Act Health Insurance Program, Medicare, Medicaid, SCHIP (state children’s health insurance) and several other health related programs. ARM Administrative Rules of Montana, the rules which govern the programs authorized by the Montana legislature.
- Glossary: Pre Admission Screen Resident Review [PASRR]Pre Admission Screen Resident Review, refers to the Centers for Medicare and Medicaid funded program that is responsible for screening individuals for nursing home level of care. When an individual seeks nursing home care a level one screen must be completed by a state sanctioned entity. If the screening determines that the individual meets the level of care a second screen, or level 2 screening is completed to determine if the individual has a mental health disability or a developmental, intellectual disability and requires specialized services while residing in a nursing facility.
- Glossary: State Health Insurance Assistance Program [SHIP]A state program that gets funding from the federal government to provide free local health coverage counseling to people with Medicare.
- Glossary: Creditable CoverageHealth insurance coverage under any of the following: a group health plan; individual health insurance; student health insurance; Medicare; Medicaid; CHAMPUS and TRICARE; the Federal Employees Health Benefits Program; Indian Health Service; the Peace Corps; Public Health Plan (any plan established or maintained by a State, the U.S. government, a foreign country); Children’s Health Insurance Program (CHIP); or, a state health insurance high risk pool. If you have prior creditable coverage, it will reduce the length of a pre-existing condition exclusion period under new job-based coverage.
- Glossary: Donut Hole, Medicare Prescription DrugMost plans with Medicare prescription drug coverage (Part D) have a coverage gap (called a "donut hole"). This means that after you and your drug plan have spent a certain amount of money for covered drugs, you have to pay all costs out-of-pocket for your prescriptions up to a yearly limit. Once you have spent up to the yearly limit, your coverage gap ends and your drug plan helps pay for covered drugs again.