Medicare Terms

2. in this type of plan you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network
4. a fixed amount one pays to receive a medical service
6. in this type of health plan you can only go to doctors, other health care providers, or hospitals in the plan’s network except in an urgent or emergency situation
9. a monthly summary sent to an individual to let them know what services were billed, what was paid by whom, and what amount the individual is responsible to pay
10. a status for individuals starting when one is formally admitted to a hospital with a doctor’s order
11. the periodic payment to Medicare, an insurance company, or a health care plan for health or prescription drug coverage
12. a provider who is part of/participates in the Blue Cross Blue Shield of Michigan Medicare Advantage PPO network
14. the amount one pays annually before the plan begins to pay

1. a status for individuals getting emergency department services, observation services, surgery, lab tests, X-rays, or any other hospital services, and the doctor hasn’t written an order to admit them to a hospital as an inpatient
3. the percentage you pay for covered services after you have met your deductible.
5. means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services.
6. care usually given when an individual has decided that they no longer want care to cure terminal illness and/or one’s doctor has determined that efforts to cure an illness aren’t working
7. a written order from a primary care doctor for a patient to see a specialist or get certain medical services
8. is long lasting, used for a medical reason, not usually useful to someone who is not sick/injured, and used in an individual’s home.
13. permanent kidney failure requiring dialysis or a kidney transplant
15. the plan contract that gives detailed information about the plan, including: what is and is not covered, what an individual pays, etc.