Insurance Terms: Medicare

A request for payment that is submitted to Medicare

A Medicare program to help people with limited income and resources pay Medicare prescription drug program costs, like premiums, deductibles, and coinsurance

Type of Medigap policy available in some states where beneficiaries choose from a standardized Medigap plan

Begins with the first day of hospitalization and ends when the patient has been out of the hospital for 60 consecutive days

A list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits

The temporary hospitalization of a hospice patient for the purpose of providing relief from duty for the nonpaid person who has the major day-to-day responsibility for the care of the terminally ill, dependent patient

Enrollment period for Medicare Part B held January 1 through March 31 of each year

Reimburses institutional providers for inpatient, hospice, and some home health services

Prescription drug coverage added to the original Medicare plan

Involves a team-oriented approach that addresses the medical, physical, social, emotional, and spiritual needs of the terminally ill patient

The action a person can take if they disagree with a Medicare coverage or payment decision

The federal health insurance program for: People who are 65 or older Certain younger people with disabilities People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)

The periodic payment to Medicare, an insurance company, or a health care plan for health or prescription drug coverage

The amount one must pay for health care or prescriptions before Original Medicare, Medicare Advantage Plan, Medicare drug plan, or one’s other insurance begins to pay

Includes managed care plans and private fee-for-service plans, which provide care under contract to Medicare and may include such benefits as coordination of care, reductions in out-of-pocket expenses, and prescription drugs.

Fee-for-service or traditional pay-per-visit plans for which beneficiaries are usually charged a fee for each health care service or supply received

Medical or other health services given to a patient using a communications system by a practitioner in a location different than the patient's

Reimburses noninstitutional health care providers for outpatient services