Medicare Definitions
- Deductibles
- The out-of-pocket amount you must pay for medical care before Medicare or your supplemental insurance pays.
- Centers for Medicare & Medicaid Services (CMS):
- CMS administers Medicare, the nation's largest health insurance program, which covers 39 million Americans. Medicare provides health insurance to people age 65 and over, and those people who have permanent kidney failure and people with certain disabilities. For more information about Medicare visit the Medicare Web Site at www.medicare.gov.
- Medicare
- A Federal Health Insurance Program for persons age 65 and older or certain disabled persons.
- Medicare - Part A
- Hospital insurance which helps to pay expenses for inpatient hospital care, outpatient care delivered in hospital outpatient departments, skilled nursing facility care, home health care and hospice care.
- Medicare - Part B
- Medical insurance which helps pay for doctors' services, certain outpatient services, and other services not covered in Part A.
- Medigap
- Supplemental insurance plans that help pay the healthcare expenses not covered by Medicare Part A and B.
- Managed Care
- Managed care plans might be thought of as a combination insurance company and a healthcare delivery system (doctor/hospital). Like an insurance company, they cover healthcare costs in return for a premium, and like a doctor or hospital, they provide healthcare services. In addition to being called managed care plans, they also are known as prepaid or coordinated care plans, or just HMOs.
- Quality Improvement Organizations (QIOs)
- These are groups funded by the federal government to help ensure that Medicare beneficiaries receive appropriate, high quality care and implement CMS' Healthcare Quality Improvement Program (HCQIP).
See also our Medicare Beneficiary Help page.