Medicare Terms

2. Services that dont need the skills of a licensed nurse or therapist.
6. Operates for the purposes of furnishing outpatient surgical services to aptients not rquiring hospitalization.
9. Formally admitted to the hospital.
11. Approval in advance to get services.
12. Care provided to treat a non-emergency unforeseen medical illnes, injury or condition.
13. When a provideer bills a patient more than the pan's cost shareming amount for services.
14. a type of complaint that does not involve coverage or payment disputes.
17. Needed for the prevention diagnosis or treatment of medical conditions
19. The amount you may be required to pay as your share of the cost for a medical service.
20. provider with no contractual arrangement with the Health Plan

1. Rx coverage that is at least as much as Medicare's standards for Rx coverage.
3. Coverage decisions to determine whetherh an item or service should be covered and at what cost.
4. A geographic area where the Health Plan accepts members
5. Services provided on a continuous, daily basis in a facility.
7. A percentage of the total amount paid for a service.
8. Insurance to fill in "gaps" in original Medicare
10. document that explains your coverage.
11. The periodic payment for health and/or Rx coverage.
15. services incldues physical, speech, language and occupational.
16. The process of ending your membership in our plan
18. medical equipment that is ordered by Dr. for use at home.