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MMA 2003

Glossary

This glossary explains terms in the Medicare program, but it is not a legal document. The official Medicare program provisions are found in the relevant laws, regulations, and rulings.

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A B C D E F G H I J K L M
 
N O P Q R S T U V W X Y Z


Term Definition
GAPS

The costs or services that are not covered under the Original Medicare Plan.

GATEKEEPER

In a managed care plan, this is another name for the primary care doctor. This doctor gives you basic medical services and coordinates proper medical care and referrals.

GENERAL ENROLLMENT PERIOD (GEP)

The GEP is January 1 through March 31 of each year. If you enroll in Part B or Part A (if you don't get it automatically without paying a premium) during the GEP, your coverage starts on July 1. (See Enrollment.)

GERONTOLOGY*

The study of, and learning about, older people and the process of aging.

GRIEVANCE

A complaint about the way your Medicare health plan is giving care. For example, you may file a grievance if you have a problem with the cleanliness of the health care facility, problems calling the plan, staff behavior, or operating hours. A grievance is not the way to deal with a complaint about a treatment decision or a service that is not covered.

GROUP HEALTH PLAN

A health plan that provides health coverage to employees, former employees, and their families, and is supported by an employer or employee organization.

GROUP OR NETWORK HMO

A health plan that contracts with group practices of doctors to give services in one or more places.

GUARANTEED ISSUE RIGHTS (ALSO CALLED "MEDIGAP PROTECTIONS")

Rights you have in certain situations when insurance companies are required by law to sell or offer you a Medigap policy. In these situations, an insurance company can't deny you insurance coverage or place conditions on a policy, must cover you for all pre-existing conditions, and can't charge you more for a policy because of past or present health problems.

GUARANTEED RENEWABLE

A right you have that requires your insurance company to allow you to automatically renew or continue your Medigap policy, unless you commit fraud or do not pay your premiums.

*NOTE: An asterisk (*) after a term means that this definition, in whole or in part, is used with permission from Walter Feldesman, ESQ., Dictionary of Eldercare Terminology, Copyright 2000.

This glossary explains terms in the Medicare program, but it is not a legal document. The official Medicare program provisions are found in the relevant laws, regulations,and rulings.
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Date Last Updated: September 23, 2004

 

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