Explanations of the words and phrases used by Medicare are in the Medicare Glossary.
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Occupational Therapist — A rehabilitation professional who teaches people to compensate for functional limitations as a result of an injury, illness or disability by learning skills and techniques needed to perform activities of daily living and optimize independence.
Ombudsman Programs — Independent, nationwide, federally-funded services that work to resolve problems between residents and assisted living facilities, nursing homes and other residential care facilities.
Oncologist — A physician who specializes in cancer, including chemotherapy.
Ophthalmologist — A physician who specializes in diseases and disorders of the eye. Prescribes medication, glasses and contact lenses, and often performs surgery.
Orthopedic Surgeon — A physician who specializes in musculoskeletal problems such as fractures, tendon injuries, dislocations and arthritis. Treatments include medication, surgery and physical therapy.
Otolaryngologist — A physician who specializes in disorders of the ears, nose and throat (ENT). Also known as an ENT physician.
Out-of-Pocket Maximum — The maximum amount of money you will be required to pay per year for your health insurance plan’s deductibles and coinsurance. This maximum may apply to each family member, or to an entire family. The maximum amount is in addition to your premiums.
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Paid-Up Policy — After your insurance policy has been in force for a period of time defined in the policy, you may be entitled to nonforfeiture benefits. If you have one of those policies and you prematurely stop paying the required premiums, your policy becomes paid-up. You don’t pay any more premiums, but the benefits you receive under the policy will be determined based on the amount of premiums you have already paid, not on the level of benefits you originally purchased.
Paratransit Services — Specialized transportation, such as a wheelchair accessible van, for seniors and other people with disabilities. These services may offer transportation to senior centers, medical care, shopping malls, or specific appointments.
Partnership Policy — A type of long-term care insurance policy that allows you to protect (keep) some of your assets if you apply for Medicaid after using your policy’s benefits. Only a few states have these policies.
Personal Care (Custodial Care) — Care to help individuals meet personal needs such as bathing, dressing, eating, and other non-medical care that most people do themselves, such as using eye drops. Someone without professional training may provide this type of care. Medicare does not pay for custodial care and Medicaid pays very little.
Personal Emergency Response System (PERS) — In case of a fall or other medical emergency, this electronic device enables the user to contact help 24-hours-a-day simply by pressing a button. A number of private companies offer these systems.
Physical Therapist — A rehabilitation professional who utilizes various therapies to help people maximize mobility, and restore strength and body movement after an illness or injury such as a stroke, fall, back injury, etc.
Plan of Care — The written plan that describes the services and care you need for your health problem. Your plan of care must be prepared or approved by your doctor.
POLST (Physician Order for Life-Sustaining Treatment) — A POLST Form is a medical order for the specific medical treatments you want during a medical emergency. A POLST form turns treatment wishes outlined in a living will into medical orders. Only individuals with a serious illness or advanced frailty near the end-of-life should have this form.
POS (Point-of-Service Plan) — A type of managed care plan that combines aspects of health maintenance organizations and preferred provider organizations. POS offers the option of going to a network healthcare provider and paying a flat fee, or to an out-of-network provider and paying a deductible and/or a coinsurance charge.
Pour-over — A provision in a person’s will stating that certain assets are to be transferred (poured over) to a trust upon the death of that person.
Power of Attorney — A Power of Attorney (POA) for Finances is a legal document that is used to delegate legal authority to another person. The person who signs (executes) a POA is called the Principal. The POA gives legal authority to another person (called an Agent or Attorney-in-Fact) to make property, financial and other legal decisions for the Principal. A Principal can give an Agent broad legal authority or very limited authority. The POA is frequently used to help in the event of a Principal’s illness or disability. Unless otherwise specified, the POA applies only to assets owned directly by the Principal, not to any assets transferred into a trust by the Principal.
A simple Durable Power of Attorney enables the Agent to act for the Principal even after the Principal is not mentally competent or physically able to make decisions. A simple Durable POA may be used immediately by the Agent, and is effective until it is revoked by the Principal, or until the Principal’s death.
A Springing Durable Power of Attorney becomes effective at a future time. That is, it becomes effective upon the happening of a specific event chosen by the Principal, and spelled out in the POA. The springing event is usually the determination that the Principal is no longer competent to handle his or her affairs. The Springing POA will frequently provide that the determination of non-competency will be made by the Principal’s physician (or by the Principal’s physician and another qualified physician). A Springing POA remains in effect until the Principal’s death, or until revoked by a court.
Power of Attorney for Health Care — A written legal document in which one person (the principal) appoints another person to make health care decisions on behalf of the principal in the event the principal becomes incapacitated (the document defines incapacitation). This instrument can contain instructions about specific medical treatment that should be applied or withheld. While its purpose remains essentially the same from state-to-state, the name of this document can vary; for example, in Florida it is called an Appointment of Health Care Surrogate.
PPO (Preferred Provider Organization) — Another type of managed care plan. Members have a choice of utilizing healthcare providers in the PPO network, or hospitals, doctors and other healthcare professionals outside the plan for an additional cost.
Pre-existing Condition — An illness or disability for which you were treated or advised within a certain time period (typically 6-12 months) before applying for an insurance policy. Any pre-existing condition would not be covered during a designated time period (again typically 6-12 months) after the effective date of the policy.
Primary Care Physician — A doctor trained to give you basic care. Your primary care doctor is the one you see first for most health problems. He or she makes sure you get the care you need to stay healthy. He or she also may talk with other more specialized doctors and healthcare providers and refer you to them. In many Medicare managed care plans, you must see your primary care doctor before you see other healthcare providers.
Primary Caregiver — The person, usually the spouse or adult child, who takes on the primary day-to-day responsibility of caring for the physical, psychological and social needs of another person.
Probate — The process by which an executor (if there is a will), or a court-appointed administrator (if there is no will), manages and distributes a decedent’s property to heirs or beneficiaries.
Provider — A properly-licensed doctor, health care professional, hospital, or other health care facility, including a home health agency, that provides health care or related social services.
Psychiatrist — A physician who specializes in mental, addictive and emotional disorders. Unlike some mental health professionals, psychiatrists may prescribe medications.
Psychologist — A mental health professional who has earned a PhD in psychology. Like a psychiatrist, a psychologist specializes in mental, addictive and emotional disorders, but cannot prescribe medications.
Pulmonologist — A physician who specializes in diseases of the lungs and airways, including lung cancer, pneumonia, asthma, emphysema and COPD (chronic obstructive pulmonary disease).
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