A savings plan whereby pre-tax dollars can be used for health care expenses, providing an incentive for reduced use of health care services. Medically Necessary A term used to describe the supplies and services provided to diagnose and treat a medical condition in accordance with the standards of good medical practice and the medical community. An example of a service that is not medically necessary is that part of a stay in a facility determined by a case manager to be excessive. It may be considered excessive because the stay was too long or appropriate care is available in a less costly or more efficient setting. Medicare A federally funded program that pays for medical services to residents over age 65 and the permanently disabled.
Coverage is divided into two components.
Part A covers services such as hospitalization and post-hospital skilled nursing facility care, while Part B deals with physicians services, medical and surgical services and supplies, diagnostic tests, and clinical laboratory services. Medicare Cost Reports Reports submitted by hospitals that provide services to Medicare beneficiaries. These reports are a condition of participation in the program and contain detailed hospital data, including financial statements and utilization information. Medigap Supplemental insurance for the elderly to cover items not covered by Medicare, such as prescriptions. This coverage is available from private insurance companies.