Glossary

The period from the end of World War II through the mid-1960s marked by unusually high birth rates.

A situation in which Private Fee-for-Service Plan providers (doctors or hospitals) can charge and bill you 15% more than the plan's payment amount for services.

When a provider bills you for the balance remaining on the bill that your plan doesn't cover. This amount is the difference between the actual billed amount and the allowed amount. This happens most often when you see an out-of-network provider (non-preferred provider). These balance bill costs are in addition to what you pay out-of-pocket for out-of-network services according to your health plan coverage. An in-network provider (preferred provider) may not balance bill you for covered services.

The updated estimate of the most recent historical year.

Basic Benefits includes both Medicare-covered benefits (except hospice services) and additional benefits.

Benefits provided in Medigap Plan A. They are also included in all other standardized Medigap policies. (See Medigap Policy.)

A benchmark is sustained superior performance by a medical care provider, which can be used as a reference to raise the mainstream of care for Medicare beneficiaries. The relative definition of superior will vary form situation to situation. In many instances an appropriate benchmark would be a provider that appears in the top 10% of all providers for more than a year.

The name for a person who has health care insurance through the Medicare or Medicaid program.

A restricted public use file. An Agreement for Release of the Centers for Medicare & Medicaid (CMS) Beneficiary Encrypted Files (PDF, 13KB) data
use agreement is required.

A letter that is required with CMS Administrator's signature when Medicare
beneficiaries will be contacted to participate in a research project.