Medicare Vocabulary
MEDICARE VOCABULARY LIST
MEDICARE PART A
Helps with cost of Hospital stays and skilled nursing services as well as some skilled care following a hospital stay. Part A is a part of Original Medicare.
MEDICARE PART B
Provides help with the cost of doctor visits and additional medical services that don’t include overnight hospital stays.
MEDICARE PART D
Helps with the cost of prescription drugs. You can purchase Part D as part of a Medicare Part D coverage, a Medicare Advantage Plan, or as a stand-alone drug plan.
PRESCRIPTION DRUG PLAN (PDP)
Prescription drug coverage that can be a stand-alone plan or a part of a Medicare Advantage plan. This is sometimes called Medicare Part D.
Medicare
A program run by the federal government that helps provide health care for:
- People over the age of 65
- People under the age of 65 with certain disabilities
- People of all ages with permanent kidney failure requiring dialysis or a kidney transplant
Medicaid
A program funded by the federal and state governments that pays for medical assistance for low-income families and individuals. This partnership is designed to ensure that America’s sick, aged, and impoverished are cared for.
Medicare Advantage
A type of Medicare Plan that provides you with both hospital and doctors care through private companies that manage your care. Normally Medicare pays these private companies a set amount per person and you pay the rest of the cost through co-pays, deductibles, premiums, and co-insurance.
Medicare Supplement Policy
An insurance policy you buy from a private insurance company that pays for all or some of the cost not covered by Medicare such as copays and deductibles. This insurance helps pay for the gaps in coverage you have to pay for when using Original Medicare (Parts A and B), which is why it is sometimes called a Medigap policy. These policies are also named with letters A, F, G, and N. Do not confuse them with Original Medicare.
Social Security Administration (SSA)
An agency in our government which is in charge of the Social Security System.
Special Enrollment Period
A period of time that you can join or leave an insurance plan separate from regular enrollment periods.
Original Medicare (OM)
A commonly used term for Part A and Part B of Medicare.
Medicare Annual Enrollment Period
From October 15th through December 7th of each year when you may enroll in, change your prescription drug plans and Medicare Advantage plans.
Creditable Drug Coverage
Prescription drug insurance that is better than or as good as coverage provided through a Medicare plan.
Guaranteed Issue (GI)
Guaranteed Issue means you cannot be turned down or charged more for a policy by an insurance company due to pre-existing conditions, your past health conditions.
Dual Eligible
If you are dual eligible you are qualified for both Medicare and Medicaid.
Coverage Gap
A hole in your prescription drug coverage that results in a higher payment from you often referred to as a Donut Hole.
Extra Help
A Medicare Program that helps lower income individuals pay Medicare prescription drug costs, such as deductibles, premiums, and co-insurance.
Formulary
A list of Prescription Drugs that are covered by Medicare Part D or your insurance plan.
Initial Enrollment Period
Three months before the first day of the month that you turn 65 continuing 90 days after the last day of your birthday month. During this initial enrollment period, you will be able to sign up for Medicare plans.
Low or Limited Income Subsidy (LIS)
A program operated by the Social Security Administration that offers help with prescription drug costs for you when you meet the income and asset requirements.
Appointments are available at no charge or obligation to enroll, click the link below to request a virtual, in-person or telephone appointment or give us a call at (800) 452-6826.
NOT AFFILIATED WITH OR ENDORSED BY THE U.S. GOVERNMENT OR THE FEDERAL MEDICARE PROGRAM.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Plans are insured or covered by a Medicare Advantage (HMO, PPO and PFFS) organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
Each insurer has sole financial responsibility for its products. Enrollment in a Medicare plan depends on contract renewal, plan availability, and eligibility. This is a solicitation of insurance. A licensed insurance agent/producer may contact you.
