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O
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 – See Long-Term Care Ombudsman Programs.
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.
P
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 – see Custodial Care.
Personal Emergency Response System – 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. For more information, click on Independent Living — resources to help seniors stay in their own home.
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.
Point-of-Service Plan (POS) – 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. POS Plans are not currently available to Medicare beneficiaries.
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 written legal document in which one person (the principal) appoints another person to manage the principal’s financial affairs. Even though the intent is that the power of attorney will not take effect until the principal becomes unable to handle his or her own affairs, it actually takes effect on the date it is signed, unless otherwise specified. And, unless otherwise specified, the durable financial power of attorney applies only to assets owned directly by the principal, and not to any assets transferred into a trust by the principal. Unlike an ordinary power of attorney, a durable power of attorney remains in effect even after the principal can no longer manage his or her own affairs. Here are 2 helpful articles: Medical and Financial Powers of Attorney and Helping a Loved One Make a Power of Attorney.
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. Here are 2 helpful articles: Medical and Financial Powers of Attorney and Helping a Loved One Make a Power of Attorney.
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.
Preferred Provider Organization (PPO) – 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. Beginning in 2003, PPO plans are available to Medicare beneficiaries in 23 states.
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.