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

case mix adjustment

Change in payment to a health plan or provider to avoid overpaying or underpaying when health status or likely use of services varies from average.

Cash and Counseling

A former Medicaid program in some states that allowed certain Medicaid beneficiaries, frail elders and adults with disabilities to purchase their own personal care and related services. Medicaid provided a monthly allowance, the amount of which is determined after...

catastrophic health insurance

Health insurance that provides protection against the high cost of treating severe or lengthy illnesses. Such policies cover all or most medical expenses above a relatively high specified amount.

categorical eligibility

Medicaid’s eligibility pathway for individuals who can be covered. The program’s 25+ categories have been organized into five broad groups – children, pregnant women, adults in families with dependent children, individuals with disabilities and the...

Center for Consumer Information and Insurance Oversight

Created by the Affordable Care Act (ACA) to ensure compliance with the new insurance market rules, this agency of the U.S. Dept. of Health and Human Services oversees the medical loss ratio rules and assists states in reviewing insurance rates. In addition, it...