Glossary
Please note that the definitions included in this Glossary reflect the manner in which these terms are used on Medicare in general.
A private company that offers Medicare coverage to people who receive railroad retirement benefits.
An independent agency in the executive branch of the federal government that handles benefits for U.S. railroad workers and their families, like retirement, unemployment, and health care including Medicare coverage.
Is the first level of the Part C appeals process performed by your Medicare health plan when an initial adverse determination has been made. Note, this term is also used as the second level of the Part D appeals process when an appeal is being escalated by the Independent Review Entity (IRE).
Is the first level of the Part D appeals process performed by your Medicare health plan when an initial adverse determination has been made.
Disclaimer
This glossary explains terms in the Medicare program, but it isn't a legal document. The official Medicare program provisions are found in the relevant laws, regulations, and rulings.
