The Health Care Programs Manual glossary contains definitions of many terms related to Minnesota Health Care Programs. These definitions are intended for general reference; for complete policy information, please refer to the relevant section(s) of the manual.
Click on a letter below to link to that section of the glossary.
GA
General Assistance. A program authorized under Minnesota Statutes 256D to provide cash assistance to needy individuals and couples without children.
GAMC
General Assistance Medical Care. A Minnesota Health Care Program providing medical care to people receiving GA cash benefits, or who are ineligible for medical coverage through MA. The ineligibility for MA cannot be due to program non-compliance.
GAMC - Hospital Only (GHO)
A Minnesota Health Care Program for people who do not qualify for MA or MinnesotaCare and do not qualify for full GAMC benefits due to excess income or assets. Benefits under this program are limited to inpatient hospital charges and physician's services received during the inpatient hospitalization.
General Assistance (GA)
A program authorized under Minnesota Statutes 256D to provide cash assistance to needy individuals and couples without children.
General Assistance Medical Care (GAMC)
A Minnesota Health Care Program providing medical care to people receiving GA cash benefits, or who are ineligible for medical coverage through MA. The ineligibility for MA cannot be due to program non-compliance.
General Enrollment
Also known as Open Enrollment. A term used by the insurance industry, as well as by DHS, for a time period during which a person can change coverage or enroll in a health plan.
GHO
GAMC - Hospital Only. A Minnesota Health Care Program for people who do not qualify for MA or MinnesotaCare and do not qualify for full GAMC benefits due to excess income or assets. Benefits under this program are limited to inpatient hospital charges and physician's services received during the inpatient hospitalization.
Good Cause
The circumstances beyond a person's control which keep the person from following program requirements or specific eligibility conditions, such as premium payment or cooperation with medical support.
Good Cause Committee
Group of people who evaluate, approve or deny good cause claims for medical and child support referrals.
Goods and Services Statement
A document which lists the merchandise and services the owner of a burial agreement has agreed to purchase from a funeral provider. A goods and services statement must accompany all burial agreements regardless of the funding source.
Grantor
The person or entity which creates or establishes the trust. Also called the trustor or settlor.
GRH
Group Residential Housing. A group living situation which has a fixed rate contract with a county to provide room and board for MSA or GA clients. This includes foster care settings. It does not include battered women's shelters or medical care (Title XIX) facilities.
Gross Income
Total earned and unearned income that is available before any deductions or disregards are applied.
Gross RSDI
The RSDI benefit amount before deducting the Medicare premium and other withholdings.
Group Health Care Coverage
Other health care coverage that is available to individuals who are members of a defined group, such as eligible employees and former employees of a particular employer or members of a union and their eligible dependents. Group health care coverage also includes COBRA coverage.
Group Home
A specialized facility providing 24-hour care for no more than 10 children, including the group home parents' own children under age 21.
Group Living Arrangement
A public or private non-profit facility certified under Section 1616(e) of the Social Security Act or a comparable state law or rule which serves no more than 16 people. This may include ICF/MRs.
Group Residential Housing (GRH)
A group living situation which has a fixed rate contract with a county to provide room and board for MSA or GA clients. This includes foster care settings. It does not include battered women's shelters or medical care (Title XIX) facilities.
Guardian
A person appointed by the court to provide for the care, comfort and maintenance needs of a minor or incapacitated person who is known as the ward.
Guardianship Account
An account established at a financial institution in the name of a guardian who acts on behalf of and administers the funds for the benefit of a minor under age 18 or a person who is incapacitated or otherwise unable to handle financial transactions.
Halfway House
A place that provides a temporary residence for people waiting for an institutional placement or for people who have left an institution and are preparing to re-enter the community.
HCAPP
Health Care Application. A form which people can use to apply for Minnesota Health Care Programs.
Health Care Application (HCAPP)
A form which people can use to apply for Minnesota Health Care Programs.
Health Care Programs
A group of health coverage programs available through the State of Minnesota to people who qualify including: MinnesotaCare, Medical Assistance (MA) which includes QMB, QWD, SLMB, QI, MA-EPD, and federally funded waiver programs, General Assistance Medical Care (GAMC), General Assistance Medical Care - Hospital Only (GHO), and Transitional MinnesotaCare.
Health Insurance Information Form (HIIF)
A DHS form (DHS-1922 or -1922B) used to gather other health care coverage information.
Health Insurance Portability and Accountability Act (HIPAA)
A federal law passed in 1996 that protects health insurance coverage for workers and their families when they change or lose their jobs. Title II Administration Simplification provides national uniformity of transaction coding and national identifiers for providers. Data privacy is included in Title II.
Health Maintenance Organization (HMO)
An organization licensed by the Department of Health to provide all defined health care benefits to people in return for a capitated payment.
Health Plan
An organization contracting with the State to provide health services to enrollees covered by a Minnesota Health Care Program in exchange for a monthly capitation payment. A health plan may be a HMO or other defined group of medical providers. Also referred to as a managed care organization (MCO).
HealthQuest
The automated system for submitting health care program policy and procedural questions to DHS.
HIIF
Health Insurance Information Form. A DHS form (DHS-1922 or -1922B) used to gather other health care coverage information.
Hill-Burton Act
A federal act that gives hospitals and other health facilities money to build and remodel in return for providing a limited volume of services to people living in their area who cannot pay for health care.
HIPAA
Health Insurance Portability and Accountability Act. A federal law passed in 1996 that protects health insurance coverage for workers and their families when they change or lose their jobs. Title II Administration Simplification provides national uniformity of transaction coding and national identifiers for providers. Data privacy is included in Title II.
Home
Property an applicant or enrollee owns in whole or in part or has an ownership interest in, and in which he or she occupies, or occupied immediately prior to receiving LTC services, as the primary dwelling. A home includes the primary dwelling, all surrounding land and any building on that land, provided the land is not separated from the dwelling by property owned by another person. Land separated from the dwelling by a public right-of-way is included in the definition of the home.
Home and Community-Based Services
Services not normally covered by MA which are covered under a waiver program, including case management, homemaker services, home health aide, personal care, adult day health treatment, habilitation, respite care, and day treatment for individuals with chronic mental illness. Also known as waivered services.
Homestead
The home which is owned by and is the usual residence of the client.
Hospice
A benefit that offers comfort, care, and support to clients who are terminally ill with a life expectancy of less than six months. It also provides support to the client's family.
Hospital Leave Day
Each day an LTCF is eligible for MA payment even though the client has transferred to an inpatient hospital for medically necessary health care.
Household Report Form (HRF)
A form (DHS-2120) used by enrollees to report changes in income, assets and circumstances.
Household Goods
Items of personal property found in or near a home that are used on a regular basis; items needed by the household for maintenance, use and occupancy of the premises as a home.
Household Size
The number of people included in a health care household. This number is used to determine income and asset eligibility and premium amount, if applicable.
HRF
Household Report Form. A form (DHS-2120) used by enrollees to report changes in income, assets and circumstances.
Human Services Judge
A person who presides over an appeal hearing and issues a recommendation on the appealed matter to the Commissioner of DHS. Also known as a Referee. An appeal is also known as a fair hearing.
IBA
Irrevocable Burial Agreement. A burial agreement with an unalterable assignment to any funeral home. The irrevocable portion of this type of agreement cannot be withdrawn before the depositor’s death.
ICF/MR
Intermediate Care Facility for the Developmentally Disabled. A residential facility licensed as a health care institution and certified by the Minnesota Department of Health to provide health or rehabilitative services for persons with mental retardation or a related condition who require active treatment.
IDA
Individual Development Account. A special bank account established under the Family Assets for Independence in Minnesota (FAIM) program that helps a person save for education, purchase of a first home, or to start a business. Eligible people must have earned income and have low income and assets.
IEVS
Income and Eligibility Verification System. A set of data exchanges with other state and federal sources used to verify income and assets of MA applicants and enrollees.
IFB
Insurance-Funded Burial. A life insurance policy with an irrevocable designation of the cash surrender value (CSV) to a funeral provider as the primary beneficiary. The value of the policy is to be paid to a funeral provider in exchange for agreed-upon goods and services.
IMD
Institution for Mental Diseases. A facility for the treatment of mental diseases.
Immediate Annuity
An annuity contract under which the periodic payments will begin within one payment interval following the payment of the annuity premium. A payment interval is the period that will elapse between payments (a month, a calendar quarter, a year).
Immigrant
A person who leaves another country to settle permanently in the U.S.
Immigrant Sponsor
Any person, or public or private agency or organization, who signed an affidavit agreeing to support an immigrant (who is not the dependent child or the spouse of the sponsor) as a condition of the immigrant's entry into the U.S. Also referred to as Sponsor.
Immigration and Nationality Act (INA)
The Act (INA) which, along with other immigration laws, treaties, and conventions of the United States, relates to the immigration, temporary admission, naturalization, and removal of aliens.
Immigration and Naturalization Service (INS)
The former name of U.S. Citizenship and Immigration Services (USCIS). The federal agency responsible for immigration and citizenship.
Immigration Status
The legal status granted to a noncitizen by immigration law.
Improper Transfer
See Uncompensated Transfer.
INA
Immigration and Nationality Act. The Act (INA) which, along with other immigration laws, treaties, and conventions of the United States, relates to the immigration, temporary admission, naturalization, and removal of aliens.
Income and Eligibility Verification System (IEVS)
A set of data exchanges with other state and federal sources used to verify income and assets of MA applicants and enrollees.
Income Certification Period
Also known as Certification Period. The period of time a client can be active before the next renewal is processed. It is also the period of time for which income is calculated to determine income eligibility as well as premium or spenddown amounts.
Income Review (IR)
Also known as Six-Month Renewal. A review of income and/or assets to redetermine program eligibility for the next six-month period.
Income Withholding (Child Support)
The method through which child support payments are made for most employed non-custodial parents. The non-custodial parent's employer must withhold the child support amount from the non-custodial parent's paycheck. The employer can either mail that amount to the Child Support Payment Center in St. Paul or electronically transfer the funds to the state.
Inconsistent Information
Data or other information received that does not match the information provided by the client or other information on file.
Indemnity Policy
An insurance policy that pays benefits directly to people for each day of hospitalization or for a specified injury. Indemnity payments may cover costs not covered by other insurance but do not always limit benefits to paying for medical expenses. Consider indemnity payments as third party liability unless the insurance company designates them as income replacement.
Individual Development Account (IDA)
A special bank account established under the Family Assets for Independence in Minnesota (FAIM) program that helps a person save for education, purchase of a first home, or to start a business. Eligible people must have earned income and have low income and assets.
Individual Health Care Coverage
Other health care coverage that individuals can purchase for themselves and their dependents without having to be part of a defined group.
Individual Retirement Account
An Individual Retirement Arrangement (IRA) held in the form of a trust or account is commonly referred to as a Traditional IRA.
Individual Retirement Annuity
An Individual Retirement Arrangement (IRA) held in the form of an annuity.
Individual Retirement Arrangement (IRA)
An umbrella term used to describe a personal savings plan that provides the owner tax advantages for setting aside money for retirement. IRAs can be in the form of a trust, an account, or an annuity.
Initial Enrollment
For MinnesotaCare, the first month in which an individual or household has MinnesotaCare coverage. The initial enrollment month does not change unless there is a break in coverage of more than one full calendar month. For managed care, this term refers to the first time an individual is enrolled in a managed care organization (MCO).
Initial Premium Payment
The first monthly premium payment which an applicant must make before coverage begins.
In-Kind Income
Payment for a service in a form other than money, or receipt of non-cash gifts or non-cash contributions such as food or clothing.
Inpatient
A person admitted to a hospital. Inpatient applies to a person temporarily absent from the hospital with the approval of a physician. Inpatient does not apply to a person absent from the hospital against medical advice.
INS
Immigration and Naturalization Service. The former name of U.S. Citizenship and Immigration Services (USCIS). The federal agency responsible for immigration and citizenship.
Institution
An establishment that furnishes food, shelter, and some treatment or services to four or more people unrelated to the proprietor. An institution may be a single facility or multiple facilities owned by the same entity.
Institution for Mental Diseases (IMD)
A facility for the treatment of mental diseases.
Institutional Level of Care
A level of care that is equivalent of what would be received in a nursing facility, a hospital, or an intermediate care facility for the developmentally disabled (known as an ICF/MR).
Insurance Barriers
Eligibility criteria which govern when an applicant or enrollee may have other health coverage or access to other health coverage currently or during a specified period.
Insurance-Funded Burial (IFB)
A life insurance policy with an irrevocable designation of the cash surrender value (CSV) to a funeral provider as the primary beneficiary. The value of the policy is to be paid to a funeral provider in exchange for agreed-upon goods and services.
Interest
Money charged as a borrower's fee on a loan or money earned and paid to the holder of a bank account, loan, or other investment. Earned interest may be credited to the account or paid directly to the owner.
Intermediate Care Facility for the Developmentally Disabled (ICF/MR)
A residential facility licensed as a health care institution and certified by the Minnesota Department of Health to provide health or rehabilitative services for persons with mental retardation or a related condition who require active treatment.
Interstate Agreement
The agreement between Minnesota and North Dakota to help resolve residence disputes that addresses state financial responsibility for MA eligibility for long-term care.
Interstate Compact on the Placement of Children
An agreement among all 50 states that coordinates the movement of children across state lines for the purpose of placement in foster care, adoptive homes, group homes, residential treatment centers, or on a trial basis with a parent. See DHS web site for more information.
IR
Income Review. Also known as Six-Month Renewal. A review of income and/or assets to redetermine program eligibility for the next six-month period.
IRA
Individual Retirement Arrangement. An umbrella term used to describe a personal savings plan that provides the owner tax advantages for setting aside money for retirement. IRAs can be in the form of a trust, an account, or an annuity.
Irrevocable Burial Agreement (IBA)
A burial agreement with an unalterable assignment to any funeral home. The irrevocable portion of this type of agreement cannot be withdrawn before the depositor’s death.
Irrevocable Trust
Allows neither the person originating the trust nor the beneficiary to change the provisions of the trust.
IV-D Agency
A state, county, or private agency that is responsible for establishing paternity and collecting child support and medical support according to Title IV-D of the Social Security Act. In Minnesota, the IV-D agency is a unit within a county agency.
IV-E Adoption
Adoption assistance placements funded under Title IV-E of the Social Security Act.
IV-E Foster Care
Foster care placements funded under Title IV-E of the Social Security Act.
Joint Ownership
An ownership agreement in which two or more people own the same piece of property. Different types of joint ownership include but are not limited to joint tenancy and tenants-in-common.
Joint Tenancy
Each owner has one and the same interest and must obtain the permission of the other joint owners in order to sell their share.
Lawful Permanent Resident (LPR)
An immigrant legally admitted to the U.S. on a permanent basis under the U.S. Immigration and Nationality Act.
Lawful Temporary Resident (LTR)
A nonimmigrant legally admitted to the U.S. on a temporary basis under the U.S. Immigration and Nationality Act.
LCC
Life Care Community. An organization that contractually offers a range of continuing care services while providing flexible accommodations, which may change with the client's needs. An LCC may also be referred to as a continuing care retirement community (CCRC).
Lead Agency Case Manager
The health plan, county or tribal agency staff person who provides case coordination or case management services.
Legal Custodian
A person who is granted legal custody of a minor child by the court but who does not have legal guardianship.
Legal Instrument or Device Similar to a Trust
Any instrument that exhibits the general characteristics of a trust, but is not called a trust, is treated in the same way for MA purposes as a trust. This can include, but is not limited to, escrow accounts, investment accounts, pension funds and other similar devices managed by an individual or entity with fiduciary obligations.
LEP
Limited English Proficiency. People with limited English proficiency, or ”r;LEP,” are not able to speak, read, write, or understand the English language well enough to allow them to interact effectively with health and social services agencies and other providers.
LI
Life Insurance. A type of policy which pays a beneficiary a designated sum upon the death of the insured person. There are two basic forms of life insurance policies: term and non-term.
Lien
A legal claim against property for the satisfaction of a debt. The lien is paid off at the time the property is sold.
Life Annuity
An annuity under which the payments continue for the life of the annuitant.
Life Care Community (LCC)
An organization that contractually offers a range of continuing care services while providing flexible accommodations, which may change with the client's needs. An LCC may also be referred to as a continuing care retirement community (CCRC).
Life Estate
A possessory estate in real property held only for the duration of a specified person’s life (usually for the life of the person or people who have the life estate interest). A life estate can, however, be held for the duration of another person’s life. A life estate is a form of legal ownership that is usually created through a deed, will, or by operation of law.
Life Estate Interest
An interest in real property that is limited to the duration of the lifetime of a specified person or people.
Life Estate Mortality Table
A table used to compute the value of a life estate based on a person's age. It is issued by the Social Security Administration.
Life Estate Owner
The person with an interest in real property subject to the duration of a specified person's life. Unless the instrument establishing the life estate places restrictions on the rights of the life estate owner(s), the life estate owner has the right to possess, use and obtain profits from the property and to sell the life estate interest. The life estate owner cannot take any action concerning the interest of the remainderman. A life estate owner is also referred to as ”r;life tenant” or ”r;tenant for life.”
Life Expectancy Table
A chart used to determine whether annuitizing an annuity is a transfer for less than fair market value. It is issued by the Social Security Administration.
Life Insurance (LI)
A type of policy which pays a beneficiary a designated sum upon the death of the insured person. There are two basic forms of life insurance policies: term and non-term.
Limited English Proficiency (LEP)
People with limited English proficiency, or ”r;LEP,” are not able to speak, read, write, or understand the English language well enough to allow them to interact effectively with health and social services agencies and other providers.
Liquid Assets
Cash or other types of assets that can be easily converted to cash, such as bank accounts, stocks, bonds, certificates of deposit, some retirement accounts and money market accounts.
Long-Term Care Consultation (LTCC)
A screening program that prevents inappropriate nursing home or boarding care placement.
Long-Term Care Facility (LTCF)
A place such as a skilled nursing facility, intermediate care facility for persons with mental retardation or related conditions (ICF/MR), medical hospital, MA-covered bed in a psychiatric in-patient hospital or a SNF that is also an Institution for Mental Diseases (IMD), where a person resides or is expected to reside for 30 days or longer. Group Residential Housing (GRH) and assisted living facilities are not long-term care facilities.
Long-Term Care (LTC) Services
LTC services include skilled nursing facility (SNF) care, nursing facility care in an inpatient medical hospital or intermediate care facility (ICF, ICF/MR), or services covered by home and community-based waiver programs (CAC, CADI, DD, EW, and TBI).
Long-Term Care (LTC) Spenddown
Amount of income an enrollee is responsible for paying toward the cost of LTC services as determined by a LTC income calculation.
Long-Term Care Spouse
A person who resides in a medical or nursing facility or who receives EW services and is expected to remain in the facility or receive EW services for at least 30 consecutive days and who is married to a community spouse.
Lookback Period
A specific period for evaluating transfers prior to the date a person requests MA payment of LTC services or the date of application for GAMC.
LPR
Lawful Permanent Resident. An immigrant legally admitted to the U.S. on a permanent basis under the U.S. Immigration and Nationality Act.
LTCC
Long-Term Care Consultation. A screening program that prevents inappropriate nursing home or boarding care placement.
LTCF
Long-Term Care Facility. A place such as a skilled nursing facility, intermediate care facility for persons with mental retardation or related conditions (ICF/MR), medical hospital, MA-covered bed in a psychiatric in-patient hospital or a SNF that is also an Institution for Mental Diseases (IMD), where a person resides or is expected to reside for 30 days or longer. Group Residential Housing (GRH) and assisted living facilities are not long-term care facilities.
LTR
Lawful Temporary Resident. A nonimmigrant legally admitted to the U.S. on a temporary basis under the U.S. Immigration and Nationality Act.
Lump Sum
Cash received on a non-recurring or irregular basis that cannot be reasonably anticipated. Examples of lump sums include winnings, insurance settlements, inheritances, and retroactive payments of RSDI.