DaleyCare Medicare Glossary
Learn more about Medicare. Start with these definitions.
Some services provided by your health plan may be limited to a defined service area. If you move out of the service area for some Medicare plans, you will automatically be disqualified from that plan.
Silver Sneakers refers to the growing population of Baby Boomers and, in some cases, seniors over the age of 65. A growing number of health insurers offer “Silver Sneakers” Medicare Advantage plans, but “Silver Sneakers” also generally applies to a growing number of senior-focused programs ranging from fitness courses to workshops and senior discounts.
Skilled nursing care is care provided by a registered nurse or a licensed practical nurse and which may be covered by Medicare, Medicare, or other health plans.
A skilled nursing facility provides the staff and equipment to administer skilled nursing care, rehabilitation services or other health care services.
A social health maintenance organization is a health care insurance plan offering a complete range of coverage and benefits, including: personal care services, hearing aids, dental care, eyeglasses, prescription drug and chronic care benefits, short-term nursing home care and medical transportation services. An SHMO is more expensive, but enrollees are covered for far more services than Original Medicare.
A special election period is a set time period during which Medicare recipients can change their plan or return to Medicare. Reasons for the change of plan may include a move from the area covered by a recipient’s existing Medicare plan, a violation of policy terms by a plan provider or other reason approved by the Centers for Medicare and Medicaid Services.
If you missed your first opportunity to sign up for Medicare Part B because you were still working (or your spouse was) at age 65 and were covered by an employer group health plan at that time, an eight-month special enrollment period begins the month after your job ends, or when your previous group health coverage ends – whichever happens first.
A Medicare special needs plan (SNP) is a type of Medicare Advantage plan that provides all of the health care and services of Medicare Parts A and B to people who require special care for chronic illnesses, care management of multiple diseases, and focused care management. The plans may be limited to individuals in specific types of institutions – such as nursing homes – or beneficiaries who are dual eligible or who have specific chronic or disabling conditions.
Specified Low-Income Medicare Beneficiaries is a Medicaid program that will cover your Medicare Part B premiums if you have limited resources, an income below the poverty line, and are already receiving Medicare Part A.
federally funded programs in each state and in some territories that provide free counseling and assistance to Medicare enrollees and their families.
Through its state medical assistance office, each state provides services – including Medicaid – and helpful information to low-income citizens.