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Glossary

This glossary explains terms in the Medicare program, but it is not a legal document. The official Medicare program provisions are found in the relevant laws, regulations, and rulings.

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A B C D E F G H I J K L M
 
N O P Q R S T U V W X Y Z


Term Definition
BALANCE BILLING

A situation in which Private Fee-for-Service Plan providers (doctors or hospitals) can charge and bill you 15% more than the plan's payment amount for services.

BASIC BENEFITS

Basic Benefits includes both Medicare-covered benefits (except hospice services) and additional benefits.

BASIC BENEFITS (MEDIGAP POLICY)

Benefits provided in Medigap Plan A. They are also included in all other standardized Medigap policies. (See Medigap Policy.)

BENEFICIARY

The name for a person who has health insurance through the Medicare or Medicaid program.

BENEFIT PERIOD

The way that Medicare measures your use of hospital and skilled nursing facility services. A benefit period begins the day you go to a hospital or skilled nursing facility. The benefit period ends when you haven't received hospital or skilled nursing care for 60 days in a row. If you go into the hospital after one benefit period has ended, a new benefit period begins. You must pay the inpatient hospital deductible for each benefit period. There is no limit to the number of benefit periods you can have. (See Deductible; Skilled Nursing Facility.)

BENEFITS

The money or services provided by an insurance policy. In a health plan, benefits are the health care you get.

BENEFITS DESCRIPTION (MEDICARE SERVICES)

The scope, terms and/or condition(s) of Medicare coverage including any limitation(s) associated with Medicare fee-for-service.

BENEFITS DESCRIPTION (PLAN)

The scope, terms and/or condition(s) of coverage including any limitation(s) associated with the plan provision of the service.

BOARD AND CARE HOME

A type of group living arrangement designed to meet the needs of people who cannot live on their own. These homes offer help with some personal care services.

BOARD-CERTIFIED

This means a doctor has special training in a certain area of medicine and has passed an advanced exam in that area of medicine. Both primary care doctors and specialists may be board-certified.

*NOTE: An asterisk (*) after a term means that this definition, in whole or in part, is used with permission from Walter Feldesman, ESQ., Dictionary of Eldercare Terminology, Copyright 2000.

This glossary explains terms in the Medicare program, but it is not a legal document. The official Medicare program provisions are found in the relevant laws, regulations,and rulings.
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Date Last Updated: September 23, 2004

 

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