Medicare terms in plain language

Short explanations of the terms used throughout this website.

ESRD: End-Stage Renal Disease: permanent kidney failure requiring regular dialysis or a kidney transplant.
Entitlement: The point when a person may qualify for a Medicare benefit. It does not by itself confirm enrollment or active coverage.
Coordination of benefits: Rules for deciding which health plan processes a covered claim first.
Primary payer: The coverage that considers and pays its share of a claim first.
Secondary payer: Coverage that considers remaining covered costs after the first payer.
Part A: Medicare hospital insurance, including eligible inpatient care.
Part B: Medicare medical insurance, including many outpatient and dialysis services.
Part D: Medicare prescription drug coverage for eligible medicines not covered by Part B.
CMS-43: Application for Medicare Parts A and B based on End-Stage Renal Disease.
CMS-2728: Medical evidence report completed by the dialysis facility or transplant provider.
CMS-40B: Request for Enrollment in Medicare Part B when Part A already exists.
GHP / EGHP: Group Health Plan / Employer Group Health Plan.
COBRA: Temporary continuation of certain employer health coverage after a qualifying event.
IRMAA: Income-Related Monthly Adjustment Amount: an added Medicare premium amount for some higher-income people.
MSP: Two meanings: Medicare Savings Program (state help with Medicare costs) or Medicare Secondary Payer (rules about when Medicare pays after another insurer). This site spells out the term whenever possible.
Part B-ID: A limited immunosuppressive drug benefit for eligible people after ESRD-only Medicare ends. It is not full Medicare.