Did you just say I need a PCP with my MA plan or MAPD plan if it is an HMO, but not if it is a PPO, and if I have a MA plan I can’t have a stand-alone PDP unless it is a PFFS?
All too often individuals working with specific areas of insurance become comfortable with abbreviations and don’t realize they are overusing them. It is not at all that the individual is being inconsiderate or expecting you to know what the abbreviations mean, but they have incorporated them into their daily language almost as if they were a part of the everyday English language. If you fall victim to someone who uses abbreviations that you do not know the meaning, do not hesitate to ask them to explain the meanings of the abbreviations. If you should fall victim to an individual who is rattling off Medicare associated abbreviations, the following list of the most frequently used abbreviations and their means will help you interpret and understand what he or she is saying to you. The information will also prove helpful in reading Medicare related literature such as brochures, insurance forms and applications, articles and publications.
ADP Annual Disenrollment Period
AEP Annual Election Period
CMS Center for Medicare and Medicaid Services
COBRA Consolidated Omnibus Budget Reconciliation Act
DOB Date of Birth
DOS Date of Service
DVH Dental/Vision/Hearing
ECF Extended Care Facility
EFT Electronic Funds Transfer
EOB Explanation of Benefits
ESRD End Stage Renal Disease
F&A Fraud and Abuse
FOI Freedom of Information
FOIA Freedom of Information Act
HHS Health and Human Services (CMS is a branch of)
HIPPA Health Insurance Portability and Accountability Act
HMO Health Maintenance Organization
HRSA Health Resources Services Administration
ICEP Initial Coverage Election Period
ID Identification
IEP Initial Election Period
IOM Internet-Only Manual
IRMMA Income Related Monthly Adjustment Amount
IVR Integrated Voice Response System
LIS Low Income Subsidy
LOC Loss of Coverage
MA Medicare Advantage plan
MAPD Medicare Advantage with Prescription Drug plan
MEDPARD Medicare Participating Physician/Supplier Directory
MedSupp Medicare Supplement plan
MMA Medicare Modernization Act
MOV Move (creation of Special Election Period)
NON Nonrenewing
NON-PAR Non-Participating Provider
OEPI Open Election Period Institutionalized
OTC Over-the-Counter
PAR Participating (physician)
PCP Primary Care Physician (for an HMO)
PDP Prescription Drug Plan
PFFS Private Fee-For-Service
POS Place of Service or Point of Service (for an HMO)
PPACA Patient Protection and Affordable Care Act
PPO Preferred Provider Organization
PPV Pneumococcal Pneumonia Vaccine
QMB Qualified Medicare Beneficiary
RRB Railroad Retirement Board
Rx Prescription
SEP Special Election Period
SHIP Senior Health Insurance Program or State Health Insurance (Assistance) Program
SMI Supplemental Medical Insurance
SNF Skilled Nursing Facility
SNP Special Needs Program
SPAP State Pharmaceutical Assistance Program
SSA Social Security Administration
SSI Supplemental Security Income
SSN Social Security Number
TIN Taxpayer Identification Number
USC United States Code
VA Veterans Administration
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