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Medicare Terminology

Medicare Terminology

Medicare Terms Defined

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Lifetime Reserve Days

Lifetime Reserve Days are limited to 60 days during your life. After these reserve days are used, Medicare provides no hospital coverage after 90 days of a benefit period.

Medicare (Part A) Coverage

Hospital Services for semiprivate room and board, general nursing and miscellaneous services and supplies. Benefit period applies.

Medicare (Part B) Coverage

Medical services in or out of the hospital and outpatient hospital treatment, such as physician services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, and durable medical equipment.

Medicare Eligible Expenses

Expenses which are recognized as reasonable and medically necessary by Medicare. Physicians under Medicare may accept Medicare’s Eligible Expense as their fee amount. Your physician may also charge you more.

Skilled Nursing Facility

Provides skilled nursing care and is approved for payment by Medicare or may qualify to receive such approval. Custodial care is not an eligible expense.

Benefit Period

Defines the limit of a stay at a hospital or nursing facility and what benefits you receive for that stay.

Excess Charges

The difference between the actual charge as billed, and the approved Medicare Part B coverage charge.

Special Notes:

  • The sale of duplicate Medicare Supplemental coverage is prohibited.
  • Your coverage can never be canceled because of your age, your health, or the number of claims you make as long as you make payments when due.
  • Consult your local insurance professional for specific information.

Please feel free to contact Heritage Companies for more information

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