According to the Centers for Medicare and Medicaid (CMS), more than 59 million people in the United States have Medicare. That number is expected to grow to close to 80 million by 2030. Currently, people 65 or older and younger people with disabilities who meet all other eligibility requirements may qualify. Therefore, it is important to start becoming familiar with Medicare terms and definitions. Here are a few.
Coinsurance: an amount you may be required to pay as your share of the cost for services after you pay any deductibles. Coinsurance is usually a percentage (for example, 20 percent).
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 or hospital outpatient visit, or prescription drug. It is usually a set amount rather than a percentage — such as $10 or $20 for a doctor’s visit or prescription drug.
Coverage gap: a period of time in which you pay higher cost sharing for prescription drugs until you spend enough to qualify for catastrophic coverage. The coverage gap (also called the “donut hole”) starts when you and your plan have paid a set dollar amount for prescription drugs during that year.
Custodial care: Non-skilled personal care are activities like bathing, dressing and using the bathroom. It may also include the kind of health related care that most people do themselves, like using eye drops. In most cases, Medicare doesn’t pay for custodial care.