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-Helpful Terms-

1. Medicare**: A federal health insurance program in the United States that provides coverage primarily to individuals aged 65 and older, as well as certain younger individuals with disabilities or end-stage renal disease.  ** below is a more in-depth description of Medicare**


2. Medicaid: A joint federal and state program in the United States that provides medical assistance to low-income individuals and families, including pregnant women, children, adults, and individuals with disabilities.


3. Long-Term Care Insurance: A type of insurance policy that helps cover the costs associated with long-term care services, such as assistance with activities of daily living (ADLs) and nursing home care, in case an individual becomes unable to care for themselves due to aging, chronic illness, or disability.


4. Veterans Benefits: Various programs and services provided by the U.S. Department of Veterans Affairs (VA) to eligible veterans, including healthcare, disability compensation, pension, education and training, home loans, and more.


5. Skilled Nursing Facility: A healthcare facility that provides specialized nursing care and rehabilitative services to individuals who require a higher level of medical care and supervision due to illness, injury, or chronic conditions.


6. Rehabilitation Facility: A facility that offers comprehensive rehabilitation services, including physical therapy, occupational therapy, and speech therapy, to help individuals recover and regain their functional abilities after an illness, surgery, or injury.


7. Assisted Living Community: A residential facility that provides housing, personal care services, and support to individuals who need assistance with activities of daily living but do not require intensive medical care or supervision.


8. Independent Living Community: A residential community designed for older adults who are able to live independently and do not require assistance with daily activities. These communities often offer various amenities and social activities.


9. Memory Care Community: A specialized residential setting for individuals with Alzheimer’s disease, dementia, or other memory-related disorders. These communities provide a secure environment and tailored care to support the unique needs of residents with memory impairment.


10. 55 and Over Community: Also known as “active adult communities” or “age-restricted communities,” these are residential communities typically restricted to individuals aged 55 and older. They often offer amenities and activities tailored to the preferences and lifestyles of older adults.


11. Social Worker: A professional who helps individuals, families, and communities address and cope with social, emotional, and behavioral issues. Social workers may provide counseling, advocacy, resource coordination, and support services.


12. Certified Nursing Assistant (CNA): A healthcare professional who assists registered nurses (RNs) and licensed practical nurses (LPNs) in providing basic patient care, such as bathing, feeding, and taking vital signs, in various healthcare settings.


13. Home Care: Services provided to individuals in their own homes to assist with activities of daily living, such as bathing, dressing, meal preparation, medication management, and companionship. Home care allows individuals to receive care while remaining in their familiar environment.


14. Companion: A person who provides social support, companionship, and assistance with everyday tasks to individuals who may be elderly, disabled, or in need of some company.


15. ADLs (Activities of Daily Living): Basic self-care tasks that individuals need to perform on a daily basis, including bathing, dressing, toileting, eating, transferring (e.g., getting in and out of bed), and maintaining continence.


I hope these definitions help! It may seem simple at first glance but when you are in the midst of a stressful situation a little guide never hurts.

If you have any further questions or need additional information, feel free to ask.


**Medicare is a federal health insurance program in the United States that provides coverage primarily to individuals aged 65 and older. It was established in 1965 under the Social Security Act and is administered by the Centers for Medicare & Medicaid Services (CMS), a division of the U.S. Department of Health and Human Services (HHS). Medicare aims to help older adults and certain younger individuals with disabilities or end-stage renal disease (ESRD) access essential healthcare services.


Here are some key points and details about Medicare:


1. Eligibility: Medicare eligibility is primarily based on age, disability status, or ESRD. Individuals aged 65 and older who are U.S. citizens or permanent residents and have worked and paid Medicare taxes for at least ten years are generally eligible. Younger individuals with disabilities or ESRD can also qualify for Medicare.


2. Coverage Structure: Medicare consists of different parts that cover specific services:


   a. Medicare Part A (Hospital Insurance): Covers inpatient hospital care, skilled nursing facility care, hospice care, and some home health services.


   b. Medicare Part B (Medical Insurance): Covers medically necessary services, including doctor visits, outpatient care, preventive services, and durable medical equipment.


   c. Medicare Part C (Medicare Advantage): Private insurance plans approved by Medicare that offer Part A and Part B coverage and may include additional benefits like prescription drug coverage (Medicare Part D).


   d. Medicare Part D (Prescription Drug Coverage): Provides prescription drug coverage through private insurance plans that are approved by Medicare.


3. Original Medicare vs. Medicare Advantage: Original Medicare refers to the combination of Part A and Part B coverage provided directly by the government. Alternatively, individuals can choose to enroll in a Medicare Advantage plan offered by private insurance companies, which provide all-in-one coverage combining Part A, Part B, and sometimes Part D benefits.


4. Cost Sharing: Medicare involves cost-sharing elements, such as deductibles, copayments, and coinsurance, which vary depending on the specific services received. Some individuals may qualify for assistance programs that help cover these costs.


5. Enrollment: Initial enrollment into Medicare generally occurs during the Initial Enrollment Period (IEP), which starts three months before an individual turns 65 and extends for a total of seven months. There are also Special Enrollment Periods (SEPs) for certain circumstances, such as delaying enrollment due to having employer-sponsored coverage.


6. Additional Coverage and Assistance: Some individuals may have additional coverage through employer-sponsored plans, retiree plans, or Medicaid, which can work together with Medicare. Programs like Medicare Savings Programs (MSPs) and Extra Help are available to assist eligible individuals with low incomes in paying for Medicare premiums, deductibles, and copayments.


7. Coverage Limitations: While Medicare provides coverage for many healthcare services, certain treatments, such as cosmetic surgery, routine dental care, and long-term custodial care, are generally not covered. However, individuals can opt for private supplemental insurance, called Medigap, to help cover some of these gaps in coverage.


It’s important to note that Medicare policies and regulations may change over time. It’s advisable to consult official Medicare resources, such as the official Medicare website or reach out to Medicare representatives for the most up-to-date and accurate information regarding eligibility, coverage options, and enrollment.