Desision daytoy maipapan iti pannakataripato ti salun-atmo a nasaksakbay nga impakaammom inkaso a saanmonton a mayebkas ti kayatmo. This will let your family and your doctors know what decisions you would make if you were able to.
Apela
A request for your managed care organization to review a denial or a grievance again.
ASC/SPU
Ambulatory surgical center/short procedure unit.
Autorisasion
Pananganamong wenno panangipalubos iti serbisio.
B
Dagiti Benepisio
Services, procedures and medications that CHIP will cover for you.
C
Clinical Care Management
One-on-one help by a nurse providing education and coordination of CHIP benefits, tailored to your needs.
Complaint
A grievance that you communicate to your health insurer or plan.
Bayad nga ited ti nangala iti seguro nga pang-salun-at
A fixed amount (for example, $15) you pay for a covered health care service, usually when you receive the service. The amount can vary by the type of covered health care service.
D
Disenrollment
To stop your membership in CHIP.
Durable Medical Equipment (Natibker ken Manayon nga Armat-Medikal, DME iti Ingles)
Equipment ordered by a health care provider for everyday or extended use. Coverage for DME may include but is not limited to: oxygen equipment, wheelchairs, crutches, or diabetic supplies.
E
Emerhensia
When you reasonably believe that your health is in serious danger.
Emerhensia a Medikal a Kondision
An illness, injury, symptom, or condition so serious that a reasonable person would seek care right away to avoid harm.
Emerhensia a Medikal a Transportasion
Ground or air ambulance services for an emergency medical condition.
Panangaripato a Siled iti Emerhensia
Emergency services you get in an emergency room.
Dagiti Emerhensia a Serbisio
Evaluation of an emergency medical condition and treatment to keep the condition from getting worse.
Dagiti Mailaksid a Serbisio
Health care services that your health insurance or plan doesn’t pay for or cover.
F
Federal Poverty Level (FPL)
Poverty income thresholds by family size that are annually updated by the Census Bureau for inflation.
Panagloko
Inuulbod nga aramid (kas koma: no adda sabali a mangusar iti ID kardmo kas miembro ket agpamarang a sika dayta).
G
Reklamo
A complaint to your health insurer or plan.
H
Dagiti Serbisio ken Alikamen ti Habilitasion
Health care services such as physical or occupational therapy that help a person keep, learn, or improve skills and functioning for daily living.
Para iti salun-at a seguro
A contract that requires your health insurer to pay your covered health care costs in exchange for a premium.
Home Health Agency
A company hired by CHIP to provide care for you in your home.
Panangtaripato ti Salun-at iti Pagtaengan
Health care services a person receives in a home.
Dagiti Serbisyo ti Hospisio
Services to provide comfort and support for persons in the last stages of a terminal illness and their families.
Ti panangtaripato ti Ospital iti Saan a Maospital a Pasiente
Care in a hospital that usually doesn’t require an overnight stay.
Pannakaospital
Care in a hospital that requires admission as an inpatient and usually requires an overnight stay.
I
ID Card
Identification card – a card that says you are a CHIP member. Sika ket masapul nga addaan iti daytoy a kard iti amin nga oras.
Informed Consent
You agree to all medical treatments.
Inpatient
No naadmitarka iti maysa a hospital ket napaut ti panagyanmo dita.
M
Medical Necessity
Your health care provider decides if a treatment, admission, procedure, medical supply, equipment, service or supply is medically necessary.
Medically Necessary
Health care services or supplies needed to prevent, diagnose, or treat an illness, injury, condition, disease or its symptoms and that meet accepted standards of medicine.
Miembro
A person who is eligible for CHIP.
N
Network
The facilities, providers, and suppliers your health insurer or plan has contracted with to provide health care services.
Non-participating Provider
A provider who doesn’t have a contract with your health insurer or plan to provide covered services to you. It may be more difficult to obtain authorization from your health insurer or plan to obtain services from a non-participating provider instead of a participating provider. In limited cases, such as when there are no other providers, your health insurer can contract to pay a non-participating provider.
O
Outpatient
No inagasandaka ngem saanka nga agyan iti hospital iti agpatnag.
P
Makipaspaset a Mangipapaay Serbisio
A Provider who has a contract with your health insurer or plan to provide covered services to you.
Dagiti serbisio ti doktor
Health-care services a licensed medical physician (M.D. -Medical Doctor or D.O. -Doctor of Osteopathic Medicine) provides or coordinates.
Plano
A benefit, like Medicaid, which provides and pays for your health-care services.
Pre-authorization
A decision by your health insurer or plan that a health-care service, treatment plan, prescription drug, or durable medical equipment that you or your provider has requested, is medically necessary. This decision or approval, sometimes called prior authorization, prior approval, or pre-certification, must be obtained prior to receiving the requested service. Pre-authorization isn’t a promise your health insurance or plan will cover the cost.
Bayad iti seguro
The amount that must be paid for your health insurance or plan.
Masakupan a Naireseta nga Agas
Health insurance or plan that helps pay for prescription drugs and medications.
Dagiti Maireseta nga Agas
Drugs and medications that by law require a prescription.
Doktor nga Umuna ken Kangrunaan a Mangtaming iti Pasiente
A physician (M.D. -Medical Doctor or D.O. -Doctor of Osteopathic Medicine) who directly provides or coordinates a range of health-care services for a patient.
Mangipapaay ti Kangrunaan a Panangtaripato
A physician (M.D. -Medical Doctor or D.O. -Doctor of Osteopathic Medicine), nurse practitioner, clinical nurse specialist, or physician assistant, as allowed under state law, who provides, coordinates, or helps a patient access a range of health-care services.
Prior Authorization
The process for any service that needs an O.K. from CHIP before it can take place.
Mangipapaay Serbisyo
A physician (M.D. -Medical Doctor or D.O. -Doctor of Osteopathic Medicine), health- care professional, or health-care facility licensed, certified, or accredited as required by state law.
Direktorio ti Mangipapaay Serbisio
A list of providers who participate with CHIP to help take care of your healthcare needs.
R
Referral
When you and your primary care provider agree you need to see another doctor, your primary care provider will send you to a CHIP specialist.
Rehabilitation Services and Devices
Health-care services such as physical or occupational therapy that help a person keep, get back or improve skills and functioning for daily living that have been lost or impaired because a person was sick, hurt or disabled.
S
Self-Referred Services
Dagiti serbisio a saanmo a kasapulan ti rekomendasion ti kangrunaan a mangtaripato kenka.
Eksperto a panagaywan
Services from licensed nurses in your own home or in a nursing home.
Special Needs Unit (SNU)
A voluntary service offered by CHIP that can give you extra help in understanding and using your benefits if you have a disability or other special need.
Espesialista
A physician specialist focuses on a specific area of medicine or a group of patients to diagnose, manage, prevent or treat certain types of symptoms and conditions.
T
TANF
Temporary Assistance for Needy Families.
Treatment
The care that you may receive from doctors and facilities.
U
Maganat a Pannakataripato
Care for an illness, injury or condition serious enough that a reasonable person would seek care right away, but not so severe as to require emergency room care.
W
WIC
Women, Infants and Children program, a supplemental nutrition program that provides nutritious food, education support and health care referrals for women, infants and children.
