Assisted Living Facility (ALF)
A homelike place with staff who give help to residents, including: help with dressing, bathing, feeding, and housekeeping. Assisted Living Facilities usually give a less skilled level of care than you would get in skilled nursing facilities. Medicare does not cover care in an ALF.

Deductible (Medicare)
The amount you must pay for health care before Medicare begins to pay, either each benefit period for Part A, or each year for Part B. These amounts can change every year. (See Benefit Period; Part A; Part B.)

Deductible (Part B)
The amount you must pay for health care each calendar year before Medicare begins to pay. This amount can change every year. Deductible (Private Fee-for-Service Plan) The amount you must pay for health care before the Private Fee-for-Service Plan begins to pay. This amount can change every year.

Discharge Planning
A process used to decide what a patient needs for a smooth move from one level of care to another. This is done by a social worker (nurse, case manager, physician) or other health care professional. It includes moves from a hospital to a nursing home or to home care. Discharge planning may also include the services of hospice and home health agencies to help with the patient's home care.

Medicaid
A joint federal and state program that helps with medical costs for some people with low incomes and limited resources. Medicaid programs vary from state to state, but most health care costs are covered if you qualify for both Medicare and Medicaid.

Medicaid Only Dual Eligibles (Non-QMB, -SLMB, -QI)
Medicare beneficiaries who are entitled to Medicare Part A and/or Part B and qualify for full Medicaid benefits.

Medical Insurance (Part B)
The part of Medicare that covers doctors' services and outpatient hospital care. It also covers other medical services that Part A doesn't cover, like physical and occupational therapy. (See Medicare Part B.)

Medicare
The federal health insurance program for: people 65 years of age or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure with dialysis or a transplant, sometimes called ESRD).

Medicare Benefits Notice
A notice you get after your doctor files a claim for Part A services in the Original Medicare Plan. It says what the provider billed for, the approved amount, how much Medicare paid, and what you must pay. You might also get an Explanation of Medicare Benefits (EOMB) (for Part B services) or a Medicare Summary Notice (MSN). (See Explanation of Medicare Benefits; Medicare Summary Notice.)

Medicare Carrier
A private company that contracts with Medicare to pay Part B bills.

Medicare Coverage
Made up of two parts: Hospital Insurance (Part A) and Medical Insurance (Part B). (See Medicare Part A and Medicare Part B.)

Medicare Managed Care Plan
These are health care choices in some areas of the country. In most plans, you can only go to doctors, specialists, or hospitals on the plan's list. Plans must cover all Medicare Part A and Part B health care. Some plans cover extras, like prescription drugs. Your costs may be lower than in the Original Medicare Plan.

Medicare Medical Savings Account Plan (MSA)
A Medicare health plan option made up of two parts. One part is a Medicare MSA Health Insurance Policy with a high deductible. The other part is a special savings account where Medicare deposits money to help you pay your medical bills.

Medicare Part A (Hospital Insurance)
Hospital insurance that pays for inpatient hospital stays, care in a skilled nursing facility, home health care, and hospice care. (See Hospital Insurance.)

Medicare Part B (Medical Insurance)
Medical insurance that helps pay for doctors' services, outpatient hospital care, and other medical services that are not covered by Part A. (See Medical Insurance.)

Medicare Secondary Payer
The insurance company that pays second on a claim for medical care. This could be Medicare, Medicaid, or other insurance depending on the situation.

Medicare Part D
Medicare new Prescription Drug Plan. Benefits will be provided through two different type of plan of prescription drug plan (PDP), which is a stand-alone drug benefit, or through a Medicare Advantage Prescription Drug Plan (MA-PD), which incorporates both health care and drug benefits.

Medicare SELECT
A type of Medigap policy that may require you to use doctors and hospitals within its network to be eligible for full benefits.

Medicare Summary Notice (MSN)
A notice you get after the doctor files a claim for Part A and Part B services in the Original Medicare Plan. It explains what the provider billed for, the approved amount, how much Medicare paid, and what you must pay. You might also get a notice called an Explanation of Medicare Benefits (EOMB) for Part B services. (See Explanation of Medicare Benefits; Medicare Benefits Notice.)

Medicare Supplemental Health Insurance Policy
A Medicare supplemental health insurance policy sold by private insurance companies to fill "gaps" in Original Medicare Plan coverage. Except in Minnesota, Massachusetts, and Wisconsin, there are 10 standardized policies labeled Plan A through Plan J. Medigap policies only work with the Original Medicare Plan. (See Gaps; Supplemental Insurance.)

Skilled Nursing Care*
A level of care that must be given or supervised by licensed nurses. This care is also under the general direction of a doctor. All of your needs are taken care of with this type of service. Examples of skilled nursing care are: getting intravenous injections, tube feeding, oxygen to help you breathe, and changing sterile dressings on a wound. Any service that could be safely done by an average nonmedical person (or one's self) without the supervision of a licensed nurse is not covered.

Skilled Nursing Facility (SNF)
A facility that provides skilled nursing or rehabilitation services to help you recover after a hospital stay.

Skilled Nursing Facility Care*
A level of care that must be given or supervised by licensed nurses or other professional staff, such as physical and occupational therapists under the general direction of a doctor. All of your needs are taken care of with this type of service, including getting direct services. Examples of skilled care are: getting intravenous injections, tube feeding, oxygen to help you breathe, and changing sterile dressings on a wound, physical occupational, and speech-language therapy. Any service that could be safely performed by an average nonmedical person (or one's self) without the direct supervision of a licensed nurse is not covered.