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Plain-English Reference Guide

Glossary & Terms

Medicare, Medicaid, hospital, rehab, caregiving and long-term care language gets confusing fast. This glossary explains common terms in plain English and links to deeper guides when you need more context.

This page will keep growing as new questions come up.

Medicare Terms

Medicare

Federal health insurance mainly for people 65 and older, plus certain younger people with disabilities.

Read: Medicare vs Medicaid

Medicaid

A joint federal and state program for eligible people with limited income and resources. In California, Medicaid is called Medi-Cal.

Read: Medicare vs Medicaid

Medi-Cal

California’s Medicaid program. It may help with certain healthcare and long-term care costs for eligible people.

Read: Medi-Cal and Long-Term Care

Medicare Part A

The part of Medicare that generally helps cover inpatient hospital care, skilled nursing facility care in certain situations, hospice and some home health care.

Read: What Medicare Doesn’t Cover

Medicare Part B

The part of Medicare that generally helps cover doctor visits, outpatient care, preventive services and medically necessary services.

Read: Can I Delay Medicare Part B?

Medicare Advantage

Medicare coverage through a private insurance company approved by Medicare, often with networks, rules and prior authorization requirements.

Read: Find Your Medicare Fit

IRMAA

An income-related monthly adjustment amount that can increase Medicare Part B and Part D costs for higher-income beneficiaries.

Read: What Is IRMAA?

COBRA

Temporary continuation of employer group health coverage after certain job or life changes. COBRA and Medicare timing can get tricky.

Read: COBRA and Medicare

HSA

A Health Savings Account. Medicare enrollment can affect whether you can keep contributing to an HSA.

Read: Can I Keep My HSA After 65?

Prior Authorization

A plan requirement that certain services, drugs or care must be approved before coverage applies.

Read: Medicare Denials and Appeals

Hospital & Rehab Terms

Observation Status

A hospital classification where a patient may be in the hospital but still considered outpatient. This can affect billing and rehab eligibility.

Read: Medicare Observation Status

Inpatient

A hospital status that generally means a doctor has formally admitted the patient to the hospital.

Read: Inpatient vs Observation

Skilled Nursing Facility

A facility that can provide skilled nursing care or rehabilitation services, often after a hospital stay.

Read: Skilled Nursing Facility vs Nursing Home

Rehab

Short-term rehabilitation after illness, injury, surgery or hospitalization, often involving therapy and skilled care.

Read: Medicare Rehab Coverage

Plateau

A term sometimes used when therapy progress slows and a facility questions whether skilled rehab coverage should continue.

Read: Rehab Plateau Language

Discharge Planning

The process of deciding what care, services, equipment and follow-up are needed after leaving the hospital.

Read: Hospital Discharge Planning

Home Health

Medically necessary skilled services provided at home for eligible patients. It is not the same as full-time caregiving.

Read: Medicare and Home Health Care

Appeal

A formal request asking Medicare or a plan to review a coverage or payment decision.

Read: Medicare Denials and Appeals

Long-Term Care Terms

Long-Term Care

Ongoing support with daily living needs, such as bathing, dressing, toileting, eating, mobility or supervision.

Read: Does Medicare Pay for Long-Term Care?

Custodial Care

Help with daily living activities rather than skilled medical treatment. Medicare generally does not cover long-term custodial care when that is the main need.

Read: Skilled Nursing vs Long-Term Care

Assisted Living

A residential care setting that may help with meals, bathing, dressing, medication reminders and daily support.

Read: When Assisted Living Is No Longer Enough

Memory Care

A care setting designed for people with dementia or significant memory-related safety needs.

Read: Medicare and Dementia Care

Nursing Home

A facility that may provide long-term care, skilled nursing or both, depending on the resident’s needs and the facility.

Read: Skilled Nursing Facility vs Nursing Home

Private Pay

When care is paid directly by the individual or family instead of Medicare, Medicaid, Medi-Cal or insurance.

Read: Paying for Long-Term Care

Caregiving Terms

ADLs

Activities of Daily Living, such as bathing, dressing, toileting, eating, transferring and basic mobility.

Read: When a Parent Can’t Live Alone

Caregiver Exhaustion

The physical, emotional and mental overload that happens when caregiving demands exceed what one person can keep carrying.

Read: Caregiver Exhaustion

Fall Risk

The chance that someone may fall because of weakness, balance problems, medication effects, pain, confusion or unsafe surroundings.

Read: When a Parent Can’t Live Alone

Care Concern Log

A written record of care concerns, dates, symptoms, conversations, falls, medications and safety issues.

Read: Documenting Elder Care Concerns

Power of Attorney

A legal document that allows someone to act on another person’s behalf. Rules and authority depend on the document and state law.

Read: Caregiving Checklist

Unsafe Driving

Driving that may no longer be safe because of vision, hearing, reaction time, confusion, medications, mobility issues or health changes.

Read: Helping an Aging Parent Stop Driving

Dementia & Memory Terms

Dementia

A general term for conditions that affect memory, thinking, behavior and daily function.

Read: Medicare and Dementia Care

Delirium

A sudden change in confusion, alertness or thinking that can happen with infection, hospitalization, dehydration, medications or illness.

Read: After a Hospital Stay

Wandering

When a person with memory loss leaves a safe area or becomes lost, often creating serious safety concerns.

Read: Memory or Confusion Concerns

Sundowning

Increased confusion, agitation or restlessness later in the day or evening, often seen in some people with dementia.

Read: Medicare and Dementia Care

Insurance & Planning Terms

Final Expense Planning

Planning for end-of-life costs so family members are not left scrambling during grief.

Read: Final Expense Planning

Life Insurance Review

A review of existing life insurance coverage to see whether it still fits the family’s current needs.

Read: Life Insurance Reviews

Coverage After Divorce

Reviewing health, life and protection coverage after divorce or separation changes the family structure.

Read: Coverage After Divorce

Life Transitions

Major changes such as retirement, caregiving, divorce, death, illness or family restructuring that often require benefit and protection decisions.

Read: Life Transitions

Social Security Terms

Social Security Retirement Benefits

Monthly benefits based on work history and claiming age. This section can expand as more Social Security content is added.

Start with the main resource center

Full Retirement Age

The age when someone may receive their full Social Security retirement benefit amount, based on birth year.

Start with the main resource center
Social Security terms will expand as this resource center grows.

This glossary is for general educational purposes only and is not legal, medical, tax or financial advice. Medicare, Medicaid, Medi-Cal, Social Security and insurance rules can vary based on individual circumstances, state rules, plan type and timing.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE or your local State Health Insurance Program (SHIP) to get information on all of your options.

Not connected with or endorsed by the U.S. Government or the federal Medicare program.

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