Medicare Terms Defined

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 Eligible Expenses are 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.

Excess Charges is the difference between the actual charge as billed, and the Medicare approved Part B charge.

Medicare (Part A) - Hospital Services for semiprivate room and board, general nursing and miscellaneous services and supplies. Benefit period applies.

Medicare (Part B) - 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.

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

Special Notes:

  • The sale of duplicate Medicare Supplement 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.