Government Insurance Programs

Medicaid

A health benefit program, jointly funded by federal and state governments, designed for people with low incomes who cannot afford medical care.

CHAMPVA

Acronym for the Civilian Health and Medical Program of the Veterans Administration; the government health insurance program that covers the medical expenses of families of veterans with total, permanent, service-connected disabilities; covers spouses and dependents of veterans who die as a result of injuries sustained in the line of duty.

Centers for Medicare and Medicaid Services (CMS)

The federal agency responsible for setting up the terms of Medicare and reviewing managed care plans that want to become Medicare-covered providers; part of the Department of Health and Human Services, CMS was called the Health Care Financing Administration (HCFA) before 2001.

diagnosis-related groups (DRGs)

A system used by Medicare to establish payment for hospital stays; based on groupings of diagnostic codes that show the relative value of medical resources used throughout the nation for patients with similar conditions.

TRICARE

The Department of Defense health insurance plan for military personnel and their families; coverage extends to active or retired members of the U.S. Army, Navy, Marines, Air Force, Coast Guard, Public Health Service, and National Oceanic and Atmospheric Administration, and dependents of military personnel killed on active duty; formerly called CHAMPUS.

sponsor

The TRICARE and CHAMPVA term for enlisted military personnel through whom medical coverage is provided.

Medicare

The federal health plan that provides insurance to citizens and permanent United States res i dents 65 years and older, people with disabilities (including kidney failure), and dependent widows; divided into Part A, hospitalization insurance; Part B, outpatient insurance; Part C, Medicare Choice; and Part D, prescription coverage.

Defense Enrollment Eligibility Reporting System (DEERS)

The system used to list individuals covered through TRICARE.

HCPCS

Pronounced "hic- pics "; stands for Health Care Financing administration's Common Procedure Coding System, for use in coding services for Medicare patients.