Important Medicare Terms You Must Know

There are several terms included in Medicare which seniors need to know as policyholders. Below we’ve mentioned the ones which you’ll see used most frequently:

 

Co-pay:

 

A co-pay is basically a part of prescription medicines or medical services which the policyholder is responsible for paying.

 

Appeal:

 

An appeal is a formal complaint which a person can file if some services or drugs aren’t included in their particular Medicare coverage when they think that they must be.

 

Deductible:

 

A deductible is a sum that needs to be paid by a policyholder to take advantage of medical care prior to Medicare compensates for any such expenditures.

 

Doughnut hole:

 

A Doughnut hole is a gap found in certain Medicare drug coverages (likely to be terminated in 2020).

 

Period of enrollment:

 

The period during which a senior is allowed to switch to another plan or purchase a healthcare plan.

 

Home health care:

 

This is a short-term care offered whilst a person is recovering at his/her house from an injury or disease. A home health-care plan might also include certain medical services, supplies, equipment, and part-time skilled care services.

 

Grievance:

 

A Grievance can be defined as a formal complaint which you can make to Medicare if you feel the individual offering you the medical treatment has misbehaved with you.

 

Long-term care:

 

Medicare won’t compensate for any ongoing personal or health care which is provided by a nursing home or an assisted living service.

 

Medicare Supplement Plan:

 

This is an optional health care plan for Part A & Part B Medicare which can be purchased from a private insurance agency.

 

Hospice care:

 

Offered to seniors with a terminal medical issue (included in Medicare Part A). Other inclusions can be physical care & counseling.

 

Medicaid:

 

State and federal programs which operate separately from Medicare. Medicaid helps seniors with limited resources and low budget afford medical expenditures.

 

The Part G Medicare Supplement plans in 2019 can save you money

 

Compensates for hospital stays, certain home health-care & hospice care.

 

Part B Medicare:

 

Compensates for medical equipment, lab exams, certain medical services and physician visits.

 

Part D Medicare:

 

Coverage offered for a few generic and branded medications.

 

Out-of-pocket expenditures:

 

The amount which the policyholder will be responsible for & the one that’s covered by Medicare.

 

Skilled nursing care:

 

This is offered by Registered Nurses (RN’s) or Licensed Practical Nurses (LPN’s).

 

Premium:

 

A premium is a monthly payment you are required to pay for your healthcare coverage.