Glossary of terms for insurance transition

These words are important to know for Insurance transition


For Medicaid purposes, assets include cash, savings accounts, checking accounts, investments, stocks, bonds, etc.). 


This refers to any expense for which an insurance plan will pay. 


This is a payment that an individual will be required to make for all health services in addition to what is paid by that individual’s insurance company. 


This is the amount of money that an individual will have to pay on top of their annual insurance plan costs before the coverage of their specific plan begins to cover their medical care. Sometimes there are certain expenses, like preventive care, that will be covered without the deductible first being met.


A person that relies on another for over half of their income. Typically this is a child relying on their parents for financial support.

Durable medical equipment: 

Any assistive aid (e.g. wheelchair, walker, bath chair, crutches, etc.)


Homebound means an individual is unable to leave the home except for short and infrequent trips outside the home with the assistance of another person.


For Medicaid purposes, any income that comes from anywhere that a person applying to Medicaid receives is counted as income (e.g. employment, alimony, Supplemental Security Income, Social Security Disability Income, stock dividends etc.). 


An individual that is not claimed on another’s taxes as tat individual provides for the majorriy of their own financial livelihood.

In-home Care:

A service provided through insurance which pays a person(s) to assist an individual with two or more daily tasks.


In-network refers to healthcare facilities or providers that have negotiated with an insurance company to be a part of an individual’s healthcare plan in order to provide their services to the individual at no additional cost to them beyond their insurance premium.  


Insurance is a contract between a company and an individual that protects that individual against the financial burden that could build up due to medical expenses.

Medical supplies: 

Medical supplies is the umbrella term for a range of materials that are available for  the use of an individual in order to perform necessary healthcare tasks (e.g. incontinence supplies, ostomy supplies, injection supplies, personal protection equipment).


The amount an individual pays for the return of insurance coverage.


The insurance plan that kicks in/covers costs first.

Private Insurance:

A coverage plan purchased by an individual or employer from a private company that is not the state or federal government.


With regard to medical expenses, “out-of-pocket” expenses means the money an individual is required to pay because their insurance plan does not cover the cost.


The insurance plan that covers some or all of the remaining cost that the primary insurance did not cover.

Social Security Disability Income (SSDI):

An entitlement program from the Social Security Administration for people with disabilities based on their employment record and age.

Supplemental Security Income (SSI):

A tested program from the Social Security Administration for people with disabilities based on a test that determines their eligibility level based on their assets and income.