The Medicare Supplement Definitions:QuickMedicareSupplement.com

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The Medicare Supplement Definitions

The Medicare Supplement Definitions

So as to be able to make a sensible purchase, it is essential to become well-known with the terms used by Medicare and Medicare insurance policies. You may desire to get acquainted with the following terms:

ASSIGNMENT: The transfer by the policyholder of some or all of his or her rights under a policy to another party. If assignment is noted on the claim form, the insurance company will pay the health care provider directly. Medicare assignment means the provider will accept the Medicare-approved amounts for covered services as payment in full. The recipient would then be responsible for any unmet deductible applied to the charge, for the co-insurance and for any services that were not accepted.

COPAYMENT: Your part or percentage of health expenditure. For instance, the insurance would pay 80 cents of every dollar on the providerís charges. You pay the remaining 20 cents. With Medicare, the coinsurance would be based on Medicare-allowable charges.

DEDUCTIBLE: The amount of covered expenses you must pay before benefits become payable by the insurers.

EXCLUSIONS OR LIMITATIONS: Precise conditions, circumstances or services not covered by the policy.

GUARANTEED RENEWABLE: The insurance company continues insuring you as long as you pay the premium. The company reserves the right to non-renew all contracts in the state.

MEDICARE-ALLOWABLE CHARGES: The amount deemed reasonable by Medicare for a given medical service. Benefits are based on Medicare-allowable charges, which may be less than the providerís charges.

PRE-EXISTING CONDITIONS: A physical condition that existed before the policy became effective. Federal law does not allow Medicare supplement polices to eliminate coverage for more than six months after the effective date of the policy on the grounds that a condition existed prior to the effective date of coverage.

Companies that replace a Medicare supplement policy must waive the pre-existing waiting period on the replacement policy. If the insured has not completed the waiting period on the first policy, any period of time that was completed must be credited on the new policy. This does not apply to those who have previously not purchased a Medicare supplement policy, those who have not had a policy within the last 31 days or those who have lost or been detached from group coverage within the preceding 63 days.

MEDICARE SELECTS POLICY: A policy or certificate that includes restricted network provisions. This type of policy may involve you to use hospitals and in some cases, doctors within its network to be eligible for full benefits.

SUPPLEMENTAL (MEDIGAP) INSURANCE: You can buy supplemental coverage that pays for some things original Medicare doesnít cover, like deductibles, doctor and hospital coinsurance and emergency care outside the country. Private insurance companies offer this supplemental coverage, often called ďMedigapĒ insurance. You can occasionally continue insurance coverage through an earlier employer.

Federal regulations mandate that all Medicare supplemental policies offer the same set of benefits. Thatís why, when deciding what company to buy from, the most important factors to consider are cost and stability. There are 12 different Medicare supplement plans, labeled A-L (except in Massachusetts, Minnesota and Wisconsin), Plan A offers the fewest benefits and is usually the least expensive.

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