A plain-language reference for the words, letters, and acronyms that come up most in Medicare conversations.
October 15 – December 7 each year, when you can switch Medicare Advantage or Part D plans for the following year.
A person enrolled in Medicare and eligible to receive its benefits.
The percentage of a covered service's cost you pay after meeting your deductible.
A fixed dollar amount you pay for a covered service, such as $20 for a doctor visit.
The amount you pay out of pocket before your plan begins to pay its share.
The list of prescription drugs a Part D or Medicare Advantage plan covers.
January 1 – March 31, for people who missed their Initial Enrollment Period and don't qualify for a Special Enrollment Period.
The seven-month window around your 65th birthday when you first become eligible to enroll in Medicare.
Private insurance, sold alongside Original Medicare, that helps pay deductibles, copayments, and coinsurance Original Medicare leaves behind.
A private-plan alternative to Original Medicare that bundles hospital, medical, and often drug and extra benefits.
The group of doctors, hospitals, and pharmacies a plan has contracted with for services, often at a lower cost.
The federal government's Part A and Part B coverage, as opposed to a private Medicare Advantage plan.
The most you'll pay for covered services in a plan year before the plan covers 100% of costs.
The amount you pay, usually monthly, to keep an insurance plan active.
Medicare's hospital insurance, covering inpatient stays, skilled nursing, and hospice care.
Medicare's medical insurance, covering doctor visits, outpatient care, and preventive services.
Medicare's optional prescription drug coverage, offered through private insurers.
A window outside normal enrollment periods triggered by specific life events, like losing employer coverage or moving.
A six-month window starting when you're 65+ and enrolled in Part B, during which insurers can't deny you a Medicare Supplement policy for health reasons.
The process an insurer uses to evaluate health risk, which can affect approval or pricing outside protected enrollment windows.
Don't see the term you're looking for? Ask us directly — we're happy to explain anything in your plan documents too.
Bring your questions, your mail from Medicare, or your current plan — we'll translate it together.