Definitions of Important Terms

 Approved Amount- The amount of the hospital's charge that a payer willrecognize in calculatingbenefits. (Under Medicare, also called "Medicare AllowableCharge")

 Benefits Period- Starts the day you are admitted to a hospital or skillednursing facility (SNF) and ends when you haven't receivedhospital inpatient or SNF care for 60 consecutive days.

 Co-insurance-The percent of the approved charge that you have to payeither after you pay the Part A deductible, or after youpay the first $100 deductible each year for Part B.

 Co-payment- A type of cost sharing whereby the insured person pays aspecified flat amount per unit of service or unit of time(e.g., $10 per visit, $25 per inpatient hospital day),with the insurer paying the balance.

 Deductible- The amount you must pay before Medicare begins to payeither each benefit period for Part A, or each year forpart B.

 Managed Care Plans- Managed care plans involve a group of doctors, hospitalswho have agreed toprovide care to Medicare beneficiaries in exchange for afixed amount of money from Medicare every month.

 Medicare Medical Savings Account- A Medicare health plan option made up of two parts. Onepart is a Medicare MSA Health Policy with a highdeductible. The other part is a special savings account,called a Medicare MSA.

 Original Medicare Plan- The traditional pay-per-visit arrangement that coversPart A and Part B services.

 Private Fee-for-Service Plan- A private insurance plan that accepts Medicarebeneficiaries.

 Referral- Permission from your primary care doctor to see acertain specialist or receive certain services.

 Supplemental Insurance Policy- Many private insurance companies sell MedicareSupplemental Insurance.

 Urgently Need Care- Unexpected illness orinjury that needs immediate medical attention, but is notlife threatening.