Thesaurus of Medicare Terminology

[Pages:20]Thesaurus of Medicare Terminology

John Whitlock 12/10/2009

Contents

Contents........................................................................................................................................................ 2 Introduction .................................................................................................................................................. 3 Scope of this thesaurus................................................................................................................................. 3 About this thesaurus..................................................................................................................................... 3

How to the hierarchical display is organized ........................................................................................ 4 Understanding the alphabetical display ............................................................................................... 4 References .................................................................................................................................................... 5 Medicare thesaurus hierarchical display ..................................................................................................... 6 Medicare thesaurus : Alphabetical display .................................................................................................. 8 Appendix A: Indexed Medicare materials................................................................................................... 19

Introduction

Access to Health care and how to pay for health care is something that almost everyone of will have to deal with at one time or another in their lifetime. Of which the likelihood requiring health care services only increases with age. An important component of paying for health care is a health insurance , however for many citizens of the United States due costs associated with paying for an health insurance plan can't afford coverage. More than Forty years ago, this was especially true for the elderly who were even less able to afford health coverage yet at the same time needed it more. Then in 1965 Congress of the United States passed into law the Social Security Act of 1965. Among many other changes to the US tax code and retirement programs this legislation set into motion the agency and programs that now run and administer what many refer to simply Medicare. Technically Medicare is a single-payer (United States Government) health care system, however with changes to the laws and administration rights, Medicare is now more like a health insurance plan made up of multiple parts that can be configured and modified to base on a person's state residency and options selected to best meet their personal and budgetary needs. However, like most things that the US Government becomes involved in, this is a government run bureaucracy with all the complexity, jargon, rules and regulations most of have come to expect. What this means is that Medicare can be a challenging and confusing government sponsored program to understand and follow.

Scope of this thesaurus

This is a mini/prototype thesaurus and is by no means comprehensive of all the subject related to Medicare. In addition, there has been no attempt to include subject terms regarding past and current legislations, economics impact and studies, nor the large amount subjects regarding the academic and political criticisms of the entitlement program. Rather the scope of this prototype was limited to terms that would be useful to persons who are soon to be and currently eligible to enroll in Medicare plan. This for most part this includes people with certain disability, anyone 65 years or older. In addition, many of these people are retirees of companies who had been promised health insurance and part of their retirement benefits that their company is no longer able to financially support.

About this thesaurus

This thesaurus could be used to indexe types Medicare health insurance plans available on the market today as well as, index the programs plethora of guides and documentation

This thesaurus presents a controlled vocabulary for the art of beading and related projects. These terms can be used for indexing and retrieving documents in this subject area. Detailed classification of beads and non-beading jewelry-making supplies and techniques are outside the scope of this thesaurus. This thesaurus is a controlled vocabulary about Medicare that present descriptors in a hierarchical display and an alphabetical display.

How to the hierarchical display is organized

In the hierarchical display, descriptors are organized at the top level by primary facets. These facets include Health insurance plans, Services, Financial concerns, Locations, Service provide and Plan rules. Each facet node includes main terms that then include sibling and child (Narrower terms) by more narrow terms, sibling terms are indented at the same level as each other. Whereas child terms a indented to the right below parents (Broader terms). Several of the facets include non-indexed organizing terms, these terms are surrounded by angel bracket . These terms are included to provide indexers and user with additional guidance to how the hierarchical display is organized.

Understanding the alphabetical display

The alphabetical display include all the terms in the hierarchical display, except for the facet labels and the organizing terms that are listed in angle brackets. The terms listed in the hierarchical display are to be considered the preferred terms for the thesaurus, however non-preferred synonym terms have been listed in this part of the display for clear mapping to the preferred term. Abbreviation found in the alphabetical display are explained below.

SN Scope Note

UF Used For ? indicates the current term is the preferred term

USE Use - directs to the preferred vocabulary term that should be used

BT Broader Term - The term that is a parent to the current term and are to be considered more general.

RT Related Term (words which can be used together to give the search added meaning)

NT Narrower Term(s ) ? The term(s) that are children to the current term and are to be considered more specific.

References

Bureau of Labor Statistics, Occupational Outlook Handbook (OOH), 2008-09 Edition. Availabe from

Centers for Medicare & Medicaid Service . 42 C.F.R. ? 400.202 Definitions specific to Medicare. [Data file]. Retrieved from

- The Official U.S. Government Site for People with Medicare. Glossary and definitions. Available from

- The Official U.S. Government Site for People with Medicare. Medicare & You 2010. [Data file]. Retrieved from

Medicare thesaurus hierarchical display

Health insurance plans Medicare plans Medicare Advantage plans Preferred Provider Organization plans Health Maintenance Organization plans Medicare prescription drug coverage Original Medicare Medicare Part A Medicare Part B Medicaid Medigap

Services health care services inpatient care hospice care hospital care (inpatient) long-term care outpatient care home health care hospital care (outpatient) ambulance service emergency room service medical supplies durable medical equipment wheelchairs walkers consumable supplies prescription drugs syringes

Financial concerns out-of pocket expenses deductible costs copayments premium payments

 generic drugs savings income subsidies

Locations health care facilities hospice care facilities hospitals physical therapy facilities

Service providers health care providers doctors emergency medical technician nurses physician assistants pharmacists medical equipment suppliers pharmacies

Plan rules eligibility rules enrollment guidelines open enrollment period special election period covered benefits rules drug coverage rules catastrophic coverage rules drug formularies drug prior authorization drug tiers prescription quantity limits out-of-pocket maximum provider network rules in-network rules out-of-network rules referral requirements

Medicare thesaurus : Alphabetical display

ambulance service SN Emergency ground transportation when you need to be transported to a hospital necessary services, and transportation in any other vehicle could endanger an individual's health. BT outpatient care RT hospitals emergency room service emergency medical technician

catastrophic coverage rules SN Once a prescription drug plan's out-of-pocket limit is reached during the coverage gap, you automatically get "catastrophic coverage." Catastrophic coverage assures that once you have spent up to your plan's out-of-pocket limit for covered drugs, you only pay copayment for the drug for the rest of the year. BT drug coverage rules NT drug formularies drug prior authorization drug tiers RT copayments catastrophic coverage Medicare prescription drug plans out-of-pocket limit prescription drugs

consumable supplies SN Are medical supplies that a person buys and uses recurrently, i.e., items which "get used up" or discarded. BT medical supplies NT prescription drugs syringes RT medical equipment suppliers

copayments SN

RT

An amount that some plans require to be paid as a share of the cost for a medical service or supply, like a doctor's visit or a prescription. out-of-pocket limit health care providers prescription drugs medical supplies

covered benefits

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