S.D. Admin. R. 67:46:11:01

Current through Register Vol. 51, page 57, November 12, 2024

Section 67:46:11:01 - Definitions

Terms defined in § 67:16:01:01 have the same meaning when used in this chapter. In addition, terms used in this chapter mean:

(1) "BIA," the bureau of Indian affairs;

(2) "Coinsurance," that portion of the medical costs allowable but not payable by Medicare and for which the individual is responsible;

(3) "Deductible," the initial amount of allowable Medicare costs paid by the individual before Medicare begins paying;

(4) "Medicare," the federal health insurance program available through the social security administration for certain disabled individuals and for individuals 65 years of age or older;

(5) "OCSE," the office of child support enforcement within the department of social services;

(6) "Part A," insurance available through the Medicare program to help pay for medically necessary hospice or home health care or care in a hospital or skilled nursing facility;

(7) "Part B," insurance available through the Medicare program to help pay for medically necessary physician services, outpatient hospital services, and medical supplies;

(8) "Qualifying Individual" or "QI," a person who meets the requirements of this chapter and who is not otherwise eligible for Medicaid benefits and for whom the state pays the Part B Medicare premium;

(9) "Qualified Medicare beneficiary" or "QMB," a person who meets the requirements of this chapter and for whom the state pays the Medicare Part A and Part B premiums, deductibles, coinsurance, and copayments;

(10) "SCORE," the service corps of retired executives;

(11) "Special low-income Medicare beneficiary" or "SLMB," a person who meets the requirements of this chapter and for whom the state pays the Part B Medicare premium; and

(12) "VISTA," the volunteers in service to America.

S.D. Admin. R. 67:46:11:01

15 SDR 171, effective 5/15/1989; transferred from § 67:16:30:01, effective 8/23/1992; 19 SDR 141, effective 3/25/1993; 41 SDR 93, effective 12/3/2014.

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1.