Doctors, hospitals, pharmacies, and other healthcare providers that agree to health plan members' services and supplies at a set price are in-network providers. With some health plans, your care is only covered if you get it from in-network providers.[Read more...]
Initial Coverage Limit
Once you have met your yearly deductible, you will pay a copayment or coinsurance for each covered drug until you reach the initial coverage limit. You will then enter your plan’s coverage gap (aka, “donut hole”).[Read more...]
Initial Enrollment Period
The Initial Enrollment Period is a seven-month period when new beneficiaries can enroll in Medicare without a penalty. Most people enroll in Medicare at age 65.[Read more...]
Inpatient Care
Inpatient care refers to care provided in a hospital or other inpatient facility. Inpatients are admitted and stay at least one night depending on their condition.[Read more...]
IRMAA
Income Related Month Adjustment Amount (IRMAA) is a Medicare Part B and Medicare Part D premium surcharge that is levied on high-income earners. The surcharge amount is based on a beneficiary's adjusted gross income.[Read more...]
Lifetime Reserve Days
Medicare Part A covers up to 90 days of inpatient care per benefit period. Beneficiaries get an additional 60 days of coverage known as lifetime reserve days. Lifetime reserve days can be used once. Beneficiaries pay a coinsurance for each one used.[Read more...]
Limiting Charge
The highest amount of money you can be charged for a covered service by doctors and other health care suppliers who don’t accept Medicare-assignment. [Read more...]
Long-Term Care
a variety of services that help people with their medical and non-medical needs over a period of time. Long-term care can be provided at home, in the community, or in various types of facilities, including nursing homes and assisted living facilities.[Read more...]
MA-PD
A Medicare Advantage plan that offers Medicare prescription drug coverage (Part D), Part A, and Part B benefits in one plan.[Read more...]
Medicaid
Medicaid is a public health insurance program that provides health care coverage to low-income families and individuals in the United States.[Read more...]
Medical Emergency
When you believe you have an injury or illness that requires immediate medical attention to prevent a disability or death.[Read more...]
Medically Necessary
Services or supplies that are needed for the diagnosis or treatment of your medical condition and meet accepted standards of medical practice.[Read more...]
Medicare Advantage
Medicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B).[Read more...]
Medicare Part A
Medicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care.[Read more...]
Medicare Part A Premium
Most beneficiaries get Medicare Part A benefits (inpatient coverage) premium-free based on the number of years they paid Medicare taxes. However, beneficiaries that did not pay Medicare taxes for the required 10 years pay a monthly premium for their Part A coverage.[Read more...]