The Language of Healthcare and Long-Term Care
One way to overcome what sometimes seems an overwhelming power imbalance between professionals and lay people is to learn the language professionals speak. This is especially true in healthcare and long-term care. It's hard to carry on a conversation on equal terms if one of the parties (that would be me and you) doesn't understand the lingo. Here are a few ways to find help.
The newcomer to long-term care discussions may feel that the English language has been recreated as a series of three- or four-letter words all in capital letters. These acronyms — terms formed from the initial letter or letters of the major components of a compound term — may be chosen because many can be pronounced as real but meaningless words. Others are just combinations of letters. Fortunately, there are some easy ways to look up these odd-looking combinations and find out what they stand for, if not exactly what they mean, which requires some further work.
The Center for Medicare & Medicaid Services has a website where you can look up acronyms by the first letter or by the whole term.
For example, MA-PD stands for Medicare Advantage-Prescription Drugs; an FAC is a Free-standing Ambulatory Center; and HIPAA is the Health Insurance Portability and Accountability Act, whose name gives you no clue that its importance to you is that it protects the privacy of patient medical information. A word of warning: the entire list contains more than 4,400 acronyms.
Terms used in healthcare reform and beyond
Although long-term care is not a separate topic in the healthcare reform, otherwise known as the Affordable Care Act, it is prudent to know what changes in healthcare insurance are being implemented, especially if you are not yet eligible for Medicare but can see that day coming. The Kaiser Family Foundation has a list of definitions.
For example, a "medical home" is "A healthcare setting where patients receive comprehensive primary care services; have an ongoing relationship with a primary care provider who directs and coordinates their care; have enhanced access to nonemergent primary, secondary, and tertiary care; and have access to linguistically and culturally appropriate care."
A "Health Insurance Exchange/Connector" is "A purchasing arrangement through which insurers offer and smaller employers and individuals purchase health insurance. State, regional, or national exchanges could be established to set standards for what benefits would be covered, how much insurers could charge, and the rules insurers must follow in order to participate in the insurance market. Individuals and small employers would select their coverage within this organized arrangement. An example of this arrangement is the Commonwealth Connector, created in Massachusetts in 2006."
A "primary care provider" is "A provider, usually a physician specializing in internal medicine, family practice, or pediatrics (but can also be a nurse practitioner, physician assistant or even a healthcare clinic), who is responsible for providing primary care and coordinating other necessary healthcare services for patients."
The glossary distinguishes between a "tax credit," which is "an amount that a person/family can subtract from the amount of income tax that they owe. If a tax credit is refundable, the taxpayer can receive a payment from the government to the extent that the amount of the credit is greater than the amount of tax they would otherwise owe," and a "tax deduction," which is "an amount that a person/family can subtract from their adjusted gross income when calculating the amount of tax that they owe. Generally, people who itemize their deductions can deduct the portion of their medical expenses, including health insurance premiums, that exceed 7.5% of their adjusted gross income." People who itemize their deductions can deduct a certain portion of their medical expenses, including health insurance premiums.
Beginning in 2014 (2013 expenses), the amount that people under the age of 65 will be allowed to deduct will rise from 7.5 percent to 10 percent of their adjusted gross income. People over the age of 65 will still be allowed to deduct 7.5 percent until 2017.
Elder care definitions at length
While most definition lists tend to be short, sometimes a longer explanation is helpful. In this category, one book stands out: Walter Feldesman's Dictionary+ of Eldercare Terminology — both for its length and comprehensiveness. Mr. Feldesman, a 95-year-old attorney, has made the 993-page third edition of this book available free online through the National Council on Aging. The sections include material on adult day care centers, alternative housing facilities, long-term care insurance, home care, and much more.
The dictionary is searchable online after you create it as a PDF document.
A word of warning
Different agencies interpret the same terminology in different ways. What counts as a "benefit" in one system may not be available in another.