eldercare

Eldercare refers to programs designed specifically to meet the needs of older individuals and includes Medicare, Social Security, private health insurance and other programs (housing, law, pensions, etc.).

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end-stage renal disease (ESRD)

End-stage renal disease refers to the point when a person’s kidneys fail and the patient must either have a kidney transplant, or undergo dialysis treatments. Individuals with ESRD are automatically eligible for enrollment in Medicare.

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enrollment period

The enrollment period is a window of time set by Medicare during which you can enroll in a Medicare health insurance plan. Each type of health plan has its own enrollment period.

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exception request

If a prescription drug that you need is not on the approved list of prescription drugs, you can file a formal written exception request to Medicare, asking that the drug be approved or that the cost of the drug be lowered.

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excess charges

For an Original Medicare enrollee, the excess charge is the difference between a doctor’s fee for service and what Medicare has approved as payment for that service.

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expedited appeal

Medicare enrollee denied coverage for a claim may challenge that denial in an expedited appeal if the patient’s life or health is in serious jeopardy. Typically, an expedited appeal is resolved within 72 hours.

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extra help

Individuals with limited income and resources and who have difficulty making their Medicare premium payments are, in some cases, eligible for financial assistance through the Extra Help program.