Do You Know These Medicare Coverage Terms?

Knowing a bit of Medicare terminology can come in handy when you’re talking with your doctor or other healthcare provider.

  • Benefit period – The way original Medicare measures your use of hospital and skilled nuring facility (SNF) services.  A benefit period begins the day you’re admitted as an inpatient in a hospital or SNF.  The benefit period ends when you haven’t received any inpatient hospital care (or skilled care in a SNF) for 60 days in a row.  If you go into a hospital or a SNF after one benefit period has ended, a new benefit period begins.  You must pay the inpatient hospital deductible for each benefit period.  There’s no limit to the number of benefit periods.
  • Co-payment – An amount you may be required to pay as your share of the cost for a medical service or supply, like a doctor’s visit, hospital outpatient visit, or prescription drug.  A co-payment is usually a set amount, rather than a percentage.  For example, you might pay $10 or $20 for a doctor’s visit or prescription drug.
  • Deductible – The amount you must pay for healthcare or prescriptions before original Medicare, your prescription drug plan or your other insurance begins to pay.