Assignment: In the Original Medicare Plan, this means a doctor or health care provider agrees to accept the Medicare approved amount as full payment. If you are in the Original Medicare Plan, it can save you money if your doctor accepts assignment. You still have to pay your share of the cost of the doctor's visit.

Basic Benefits: All Medicare Supplement insurance policies must cover these basic (core) benefits:

• The Medicare Part A coinsurance amount.
• The cost of 365 extra days of hospital care during
  your lifetime after Medicare coverage ends.
• The Medicare Part B coinsurance or copayment amount.
• The first 3 pints of blood each year.

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.

Coinsurance: The percent of the Medicare-approved amount that you have to pay after you pay the deductible for Part A and/or Part B. In the Original Medicare Plan, the coinsurance payment is a percentage of the cost of the service (generally 20%).

Co-payment: In some Medicare health plans, the amount you pay for each medical service, like a doctor visit. A copayment is usually a set amount you pay for a service. For example, this could be $10 or $20 for a doctor visit. Co-payments are used for some hospital outpatient services in the Original Medicare Plan.

Deductible: The amount you must pay for health care, before Medicare begins to pay, either for each benefit period for Part A, or each year for Part B. These amounts can change every year.

Excess Charges: The difference between a doctor's (or other health care provider's) actual charge and the Medicare-approved payment amount. The Excess Charge may be limited by Medicare or the state.

Home Health Care: Skilled nursing care and certain other health care you get in your home for the treatment of an illness or injury.

Hospice Care: A special way of caring for people who are terminally ill, and for their family. This care includes physical care and counseling. Hospice care is covered under Medicare Part A (Hospital Insurance).

Lifetime Reserve Days: Sixty days that Medicare will pay for when you are in a hospital for more than 90 days. These 60 reserve days can be used only once during your lifetime. For each lifetime reserve day, Medicare pays all covered costs except for a daily coinsurance ($438 in 2004).

Limiting Charge: The highest amount of money you can be charged for a covered service by doctors and other health care providers who don't accept assignment. The limit is 15% over Medicare's approved amount. The limiting charge only applies to certain services and does not apply to supplies or equipment.

Medicaid: A joint federal and state program that helps with medical costs for some people with low incomes and limited resources. Medicaid programs vary from state to state, but most health care costs are covered if you qualify for both Medicare and Medicaid.

Medicare-Approved Amount: The fee Medicare sets as reasonable for a covered medical service. This is the amount a doctor or supplier is paid by you and Medicare for a service or supply. It may be less than the actual amount charged by a doctor or supplier. The approved amount is sometimes called the "Approved Charge."

Medicare Supplement Insurance: An insurance policy sold by private insurance companies to work hand in hand with the Original Medicare Plan coverage. Except in Massachusetts, Minnesota and Wisconsin, there are 12 standardized plans labeled Plan A through Plan L. Medicare Supplement coverage only works with the Original Medicare Plan.

Open Enrollment Period: A one-time-only six month period when you can buy any Medicare Supplement Insurance Policy you want that is sold in your state. It starts when you are enrolled in Medicare Part B and you are age 65 or older, or if you are disabled in some states and are enrolled in Medicare Part B. You cannot be denied coverage or charged more due to past or present health problems during this period.

Original Medicare Plan: A pay-per-visit health plan that lets you go to any doctor, hospital or other health care provider who accepts Medicare. You must pay the deductible. Medicare pays its share of the Medicare-approved amount and you pay your share (coinsurance). The Original Medicare Plan has two parts: Part A (Hospital Insurance) and Part B (Medical Insurance).

Skilled Nursing Care: A level of care that must be given or supervised by Registered Nurses. All of your needs are taken care of with this type of service. Examples of skilled care are: getting intravenous injections, tube feeding, oxygen to help you breathe, and changing sterile dressings on a wound. Any service that could be safely done by an average non-medical person (or one's self) without the supervision of a Registered Nurse is not considered skilled care.

Skilled Nursing Facility: A nursing facility with the staff and equipment to give skilled nursing care and/or skilled rehabilitation services and other related health services.



Source: Medicare information obtained from "Medicare and You 2002". Source: Medicare Supplement information obtained from "Choosing A Medigap Policy"