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Medicaid
A medical assistance program for certain individuals and families with limited incomes and resources. Medicaid is jointly funded by the federal and state governments and managed by the states. It includes programs that help pay Medicare premiums and cost-sharing.
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Medical Savings Account (MSA)
A type of Medicare Advantage plan that combines a special bank savings account with a high-deductible Medicare Advantage plan. The money in the savings account can be used only for medical expenses.
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medically necessary care
Services or supplies that are needed to diagnose or treat a medical condition, according to the accepted standards of medical practice.
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Medicare
A federal government health program for:
• People age 65 or older
• People under age 65 with certain disabilities
• People of all ages with End Stage Renal Disease (ESRD)
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Medicare Advantage
A type of plan offered by a private company that provides all the coverage offered by Medicare Parts A and B plus other benefits. Many Medicare Advantage plans also include prescription drug coverage.
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Medicare Advantage Disenrollment Period
The period each year from January 1 to February 14 when you can leave a Medicare Advantage plan. You will return to Original Medicare automatically when you disenroll from the Medicare Advantage plan. If your Medicare Advantage plan included prescription drug coverage, you can enroll in a Medicare Part D prescription drug plan during this time.
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Medicare-approved amount
The amount Medicare determines to be reasonable for a covered service. Providers who “accept assignment” agree to accept this amount as payment in full. Providers who accept Medicare but not assignment can charge up to 15% above this amount.
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Medicare assignment
Medicare assignment refers to the Medicare-approved amount for payment in full for a medical service. Doctors can choose to accept assignment or not. If they do not accept assignment, then they may charge more than the Medicare-approved amount for a service. This means you may pay more.
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Medicare Open Enrollment
The time period each year during which you may enroll in Medicare prescription drug plans (Part D) and Medicare Advantage (Part C) plans. Medicare Open Enrollment is October 15 through December 7 every year.
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Medicare Savings Account plan (MSA)
A type of Medicare Advantage plan that combines a high-deductible health plan with a savings account. You use money from the savings account to pay your health care costs.
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Medicare Savings Program
Medicare program that helps eligible people pay some or all of their Medicare premiums. In some cases, the program may also help with deductibles copayments and coinsurance.
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Medicare SELECT
A special type of Medicare supplement insurance plan that requires you to use specific hospitals, and in some cases, specific doctors, to get your full insurance benefits (except in an emergency).
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Medicare supplement insurance
A plan provided by a private insurance company that pays for some of the cost sharing, such as deductibles, copays and coinsurance, in Original Medicare coverage. Medicare supplement insurance plans are available in standard types of plans. Each plan is named with a letter of the alphabet. Don’t confuse Medicare supplement plans A, B, C and D with Medicare Parts A, B, C and D.
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Medicare supplement insurance Open Enrollment Period
The time period during which you are guaranteed the right to buy any Medicare supplement insurance plan available where you live. This period includes the six months after you are enrolled in Medicare Part B. During this time, the insurer cannot refuse to sell you a plan or charge a higher premium due to your medical history or current health.
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Medigap
A term sometimes used to refer to Medicare supplement insurance.