Lifetime reserve days - under Medicare, a beneficiary has a lifetime reserve of 60 days of inpatient services they can use after they use more than 90 inpatient days in a benefit period.  The beneficiary must pay a daily co-insurance for each lifetime reserve day used.  As their name implies, lifetime reserve days can only be used once during a beneficiary’s life.

Long-term care - care received in a nursing home.

MCARE noncoverd drug – see self-administered drug.

Medicaid - a state insurance plan, funded by federal and state resources, for low-income people who have limited or no insurance.

Medically necessary – refers to services or supplies that are required to properly diagnose and/or treat a specific medical condition.  Services or supplies that are not deemed medically necessary by insurance may be denied.

Medicare - a federal health insurance program for people age 65 and older.  Medicare covers some people under age 65 who have disabilities or end-stage renal disease (ESRD).

Medicare number - a number assigned to every Medicare beneficiary.  This number can be found on the beneficiary’s Medicare card.

Medicare Part A - usually referred to as hospital insurance, this type of Medicare coverage helps pay for inpatient hospital, home health, hospice, and skilled nursing facility services.

Medicare Part B – this type of Medicare coverage helps pay for physician services, medical supplies, and other outpatient services not paid for by Medicare Part A.

Medicare Summary Notice (MSN) - also called an Explanation of Medicare Benefits (EOMB).   See explanation of benefits.

Medicare+Choice – an alternative to traditional Medicare insurance in the form of a Medicare managed care plan or a Medicare-approved fee-for-service plan offered by a private company.

Medigap insurance – additional insurance purchased by Medicare beneficiaries to cover co-payments, co-insurance, deductibles, and services not paid for by Medicare Part A or B.  Also known as Medicare supplement insurance.

Network - a group of doctors, hospitals, and other health care providers that have an agreement with an insurance plan to provide services to its beneficiaries.

Non-covered charges - charges for services denied or excluded by insurance.  The beneficiary may be billed for these charges.  Also called not covered amount.

Non-participating provider (non-par) – a doctor, hospital, or other health care provider that is not part of an insurance plan’s network.  Also known as out-of-network provider.

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