Glossary

When care takers do not give a person they care for the goods or services needed to avoid harm or illness.

When the Decision Memorandum is issued, the NCA is considered closed. However, the policy change is not effective until the NCD is issued.

Without the written consent of the individual, the Privacy Act prohibits release of protected information maintained in a system of records unless of 1 of the 12 disclosure provisions applies.

Written ahead of time, a health care advance directive is a written document that says how you want medical decisions to be made if you lose the ability to make decisions for yourself. A health care advance directive may include a Living Will and a Durable Power of Attorney for health care.

Written medical or scientific conclusions demonstrating the medical effectiveness of a service produced by the following:

• Controlled clinical trials, published in peer-reviewed medical or scientific journals;
• Controlled clinical trials completed and accepted for publication in peer-reviewed medical or scientific journals;
• Assessments initiated by CMS;
• Evaluations or studies initiated by Medicare contractors;
• Case studies published in peer-reviewed medical or scientific journals that present treatment protocols.

You are automatically eligible for Part B if you are eligible for premium-free Part A. You are also eligible for Part B if you are not eligible for premium-free Part A, but are age 65 or older AND a resident of the United States or a citizen or an alien lawfully admitted for permanent residence. In this case, you must have lived in the United States continuously during the 5 years immediately before the month during which you enroll in Part B.

You are eligible for premium-free (no cost) Medicare Part A (Hospital Insurance) if:

• You are 65 or older and you are receiving, or are eligible for, retirement benefits from Social Security or the Railroad Retrirement Board, or
• You are under 65 and you have received Railroad Retirement disability benefits for the prescribed time and you meet the Social Security Act disability requirements, or
• You or your spouse had Medicare-covered government employment, or
• You are under 65 and have End-Stage Renal Disease (ESRD).

If you are not eligible for premium-free Medicare Part A, you can buy Part A by paying a monthly premium if:

• You are age 65 or older, and
• You are enrolled in Part B, and
• You are a resident of the United States, and are either a citizen or an alien lawfully admitted for permanent residence who has lived in the United States continuously during the 5 years immediately before the month in which you apply.

Your ability to get medical care and services when you need them.

Your ability to get needed medical care and services.

Your decision to join or leave the Original Medicare Plan or a Medicare+Choice plan.