MEDICARE GLOSSARY

General Medicare CMS Glossary of terms you should know.

The Centers for Medicare and Medicaid Services (CMS) maintain a glossary of terms related to Medicare and Medicaid. Here are some key terms from the CMS glossary:

  • Beneficiary: A person who receives benefits from Medicare or Medicaid.
  • Coinsurance: is the portion of the cost of healthcare services that the beneficiary is responsible for paying after the deductible has been met.
  • Deductible: The amount of healthcare expenses that the beneficiary must pay before Medicare or Medicaid begins to cover the cost of care.
  • Dual Eligible: A person who is eligible for both Medicare and Medicaid and receives benefits from both programs.
  • Extra Help: A program that helps low-income Medicare beneficiaries pay for their prescription drug costs.
  • Health Insurance Marketplace: A marketplace where individuals can shop for and purchase health insurance coverage, including Medicare Advantage plans.
  • Medically necessary: healthcare services, treatments, or supplies that are required to diagnose, treat, or manage a medical condition or illness.
  • Medicare Advantage: A type of Medicare plan offered by private insurance companies that provides ancillary coverage for healthcare services, often including prescription drug coverage.
  • Medicare Part A: The part of Medicare that covers inpatient hospital care, skilled nursing care, and hospice care.
  • Medicare Part B: The part of Medicare that covers outpatient medical services, such as doctor visits and diagnostic tests.
  • Medicare Part D: The part of Medicare that provides coverage for prescription drugs.
  • Medigap: A supplemental insurance policy that helps cover some of the out-of-pocket costs associated with Medicare.
  • Provider: A healthcare professional or facility that provides healthcare services to Medicare or Medicaid beneficiaries.

The CMS glossary also provides important definitions and explanations of key terms related to Medicare and Medicaid, helping beneficiaries and healthcare professionals better understand their coverage and benefits.

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