Appendix B


Administrative law judge (ALJ)
A person who presides over one level of Medicare or Social Security appeal hearings.
Advance Beneficiary Notice of Non-Coverage (ABN)
A written warning that doctors and other providers must give you if they think Medicare may not cover the service or treatment you’re about to receive.
Annual Notice of Change
A notice that Part D and Medicare Advantage plans must send to their enrollees each September specifying changes in costs and benefits that will be made to their plans for the following year.
A formal request to reverse a decision (made by Social Security or Medicare) that you don’t agree with.
Doctors or other providers who accept Medicare patients on assignment can’t charge more than the Medicare-approved amount.
benefit period
In traditional Medicare, a benefit period begins when you’re admitted to a hospital and ends when you have stayed out of the hospital or a skilled nursing facility for 60 days.
brand-name prescription drug
A drug for which its manufacturer still has patent protection and exclusive rights to sell, often for a high price.
catastrophic drug coverage
Low-cost Part D drug coverage that kicks in after you’ve spent a certain amount out of pocket on drugs since the beginning of the year and continues until the end of the calendar year.
COBRA insurance
A temporary extension of employer coverage (usually for 18 months) after employment has ended where you pay your own share of the premiums ...

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