Term
| cost of insurance to a customer |
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| amount of out of pocket money the cardholder must pay before insurance kicks in |
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| amount/percentage of the prescription price the cardholder must pay |
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| list of medications the insurance will cover |
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| refers to different medication groups usually based on price that increase a cardholder's co-payment |
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| non-formulary medication that needs documentation from the provider of its needed use before the insurance will pay for it |
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| eclient must try and fail a particular medication, usually of lesser cost, before being approved for another medication used for the same indication that is typically more expensive |
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| public insurance that is covered by federal and state funding |
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| the single state agency responsible for providing access to medical care for Washington's most vulnerable residents. |
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| The federally matched medical aid programs under Title XIX of the Social Security Act that cover the Categorically Needy (CN) and Medically Needy (MN) programs |
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| the federally matched Medicaid and CHIP programs provide the broadest scope of medical coverage. Includes full cope of coverage for pregnant women, children, the aged, blind, and persons with disabilities |
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| A guidelines for determining governmental program eligibility based on the CPI guide from the year just completed. |
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| Federal Poverty Level (FPL) |
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| Washington State Medicaid's managed care program |
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| A prepaid comprehensive system of medical and health care services provided through a designated health care plan that contracts with Medicaid |
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| The federally matched Medicaid Program for the aged, blind, or persons with disabilities, as well as pregnant women, children, and refugees. It provides slightly less medical coverage for those with income and/or resources above CN limits |
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| The temporary assistance for needy families program, which offers cash and other benefits to families in need |
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| client able to get care from doctors and other medical providers who will accept client services card, without membership in a managed care program or health maintenance program. |
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| up to #100 test strips/lancets per 30 days-- testing 3 times daily |
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| for Insulin dependent (medicare B compliance) |
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| up to #100 test strips/lancets per 90 days-- testing once daily |
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Definition
| for non-insulin dependent (medicare B compliance) |
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