BadgerCare Plus Glossary

A

  • Advance Directive

    A decision about your health care that you make ahead of time in case you are ever unable to speak for yourself. This will let your family and your doctors know what decisions you would make if you were able to.

  • ASC/SPU

    Ambulatory surgical center/short procedure unit.

  • Authorization

     An O.K. or approval for a service.

B

  • Benefits

    Services, procedures and medications that UnitedHealthcare BadgerCare Plus will cover for you.

C

  • Clinical Care Management

    One-on-one help by a nurse providing education and coordination of UnitedHealthcare BadgerCare Plus for Kids benefits, tailored to your needs.

D

  • Disenrollment

     To stop your membership in UnitedHealthcare BadgerCare Plus.

E

  • Emergency

    When you reasonably believe that your health is in serious danger.

F

  • Federal Poverty Level (FPL)

    Poverty income thresholds by family size that are annually updated by the Census Bureau for inflation.

  • Fraud

    An untruthful act – an example is someone other than you using your UnitedHealthcare BadgerCare Plus member ID card and pretending to be you.

H

  • Home Health Agency

    A company hired by UnitedHealthcare BadgerCare Plus to provide care for you in your home.

I

  • ID Card

    Identification card – a card that says you are a UnitedHealthcare BadgerCare Plus member. You should have this card with you at all times.

  • Informed Consent

    You agree to all medical treatments.

  • Inpatient

    When you are admitted into a hospital for a length of time.

M

  • Medical Necessity

    Your health care provider decides if a treatment, admission, procedure, medical supply, equipment, service or supply is medically necessary.

  • Member

    A person who is eligible for UnitedHealthcare BadgerCare Plus.

O

  • Outpatient

    A nonhospitalized patient receiving covered services away from a hospital, such as in a physician's office or the patient’s own home, or in a hospital outpatient or hospital emergency department or surgical center.

P

  • Primary Care Physician (PCP)

    A doctor you choose to be your family physician. They have their own private practices.

  • Prior Authorization

    The process for any service that needs an O.K. from UnitedHealthcare BadgerCare Plus before it can take place.

  • Provider

    Any medical professional that UnitedHealthcare BadgerCare Plus has contracted with to take care of you.

  • Provider Directory

    A list of providers who participate with UnitedHealthcare BadgerCare Plus to help take care of your healthcare needs.

R

  • Referral

    When you and your primary care provider agree you need to see another doctor, your primary care provider will send you to a UnitedHealthcare BadgerCare Plus specialist.

S

  • Self-Referred Services

    Services for which you do not need to see your primary care provider for a referral.

  • Special Needs Unit (SNU)

    A voluntary service offered by UnitedHealthcare BadgerCare Plus that can give you extra help in understanding and using your benefits if you have a disability or other special need.

  • Specialist

    A doctor that has specific, detailed training in one certain medical field.

T

  • TANF

    Temporary Assistance for Needy Families.

  • Treatment

     The care that you may receive from doctors and facilities.

U

  • Urgent Care

    When you need care, treatment or medical advice within a 24-hour time period.

W

  • WIC

    Women, Infants and Children program, a supplemental nutrition program that provides nutritious food, education support and health care referrals for women, infants and children.

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