Medicare Glossary

A

Advance Beneficiary Notice (ABN) General

A written notice your doctor or supplier must give you before providing a service that Medicare may not cover, letting you decide whether to receive it and agree to pay if Medicare denies the claim. If you weren't given an ABN, you generally aren't responsible for payment for non-covered items.

Annual Election Period (AEP) Enrollment

Also called the Medicare Open Enrollment Period. Runs October 15 – December 7 each year. During this time you can join, switch, or drop a Medicare Advantage plan or Part D drug plan. Changes take effect January 1 of the following year.

See also: Enrollment Periods Guide

Appeal General

A formal request to Medicare, a Medicare Advantage plan, or a Part D plan to review and reconsider a coverage or payment decision. There are five levels of appeals: redetermination, reconsideration, ALJ hearing, Medicare Appeals Council, and federal district court.

Assignment (Medicare Assignment) Part B

When a doctor or supplier agrees to accept Medicare's approved amount as full payment for a service. Doctors who "accept assignment" cannot charge you more than your 20% coinsurance plus the Part B deductible. Doctors who don't accept assignment can charge up to 15% above the Medicare-approved amount (the "limiting charge").

Attained-Age Rating Medigap

A Medigap pricing method where your premium is based on your current age and increases each year as you get older. This results in the lowest initial premiums but the highest long-term costs. Compare with Issue-Age Rating and Community Rating.

See also: Medigap Guide

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B

Benefit Period Part A

The way Medicare measures your use of hospital and skilled nursing facility services. A benefit period begins the day you're admitted as an inpatient and ends when you haven't received inpatient care for 60 consecutive days. There's no limit to the number of benefit periods you can have — each one comes with a fresh Part A deductible ($1,676 in 2025).

Birthday Rule (Medigap) Medigap

A law in some states (California, Idaho, Illinois, Louisiana, Maryland, Nevada, Oklahoma, Oregon) that gives you a 30–63 day window around your birthday each year to switch to an equal or lesser Medigap plan without medical underwriting. Not a federal rule — availability varies by state.

Broker / Licensed Insurance Agent General

A licensed professional who helps you compare and enroll in Medicare Advantage or Part D plans. Brokers are typically paid commissions by insurance companies at no direct cost to you, but their guidance may be influenced by which plans they're contracted to sell. SHIP counselors offer free, unbiased help.

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C

Catastrophic Coverage Phase Part D

Starting in 2025, once you've spent $2,000 out-of-pocket on covered drugs in a year, you enter the catastrophic coverage phase and pay $0 for the rest of the year. This replaces the old 5% coinsurance that applied in prior years — a major improvement under the Inflation Reduction Act.

Coinsurance General

Your share of a covered health care cost after you've met your deductible, expressed as a percentage. For example, Medicare Part B pays 80% of the Medicare-approved amount for most services and you pay 20% coinsurance. Unlike copayments, coinsurance scales with the cost of the service.

Community Rating Medigap

A Medigap pricing method where everyone in a geographic area pays the same premium regardless of age. Also called "no-age-rated." Premiums may be higher when you're young but won't rise solely because you're getting older (though they can still increase due to inflation).

Continuous Glucose Monitor (CGM) Part B

A device that tracks blood glucose levels throughout the day. Medicare Part B covers CGMs as durable medical equipment (DME) for beneficiaries with diabetes who require insulin or are at risk of hypoglycemia. Coverage was expanded significantly in recent years.

Copayment (Copay) General

A fixed dollar amount you pay for a covered health service, usually at the time of the visit. For example, a Medicare Advantage plan might charge a $30 copay for specialist visits. Different from coinsurance, which is a percentage rather than a fixed amount.

Coordination of Benefits (COB) General

The process that determines which insurance plan pays first (primary) and which pays second (secondary) when you have more than one type of health coverage. For example, if you have employer coverage and Medicare, COB rules determine the order of payment.

Cost Sharing General

The portion of health care costs you're required to pay out of pocket, including deductibles, copayments, and coinsurance. Medicare's original cost-sharing structure has no annual out-of-pocket maximum, unlike Medicare Advantage plans (capped at $9,350 in-network in 2025).

Coverage Gap ("Donut Hole") Part D

A period in Part D drug coverage that used to require you to pay much higher drug costs. The Inflation Reduction Act effectively closed the coverage gap starting in 2025 — you now pay no more than 25% of drug costs until you hit the $2,000 out-of-pocket cap. The "donut hole" as it historically existed no longer applies.

Creditable Coverage (Part D) Part D

Prescription drug coverage from another source (such as an employer plan) that is at least as good as Medicare's standard Part D coverage. If you had creditable coverage, you won't face a late enrollment penalty when you later enroll in Part D. Employers must notify you annually whether your coverage is creditable.

Custodial Care General

Non-medical assistance with daily activities like bathing, dressing, eating, and using the bathroom (also called "activities of daily living" or ADLs). Medicare generally does NOT cover custodial care — this is a critical coverage gap. Long-term care insurance, Medicaid, or personal savings are typically needed.

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D

Deductible General

The amount you pay for covered services before your insurance begins to pay. In 2025: Part A deductible is $1,676 per benefit period; Part B deductible is $257 per year; Part D maximum deductible is $590 per year. Medicare Advantage deductibles vary by plan.

Disenrollment General

Voluntarily leaving a Medicare Advantage or Part D plan. You can disenroll during the Annual Election Period (Oct 15–Dec 7), the Medicare Advantage Open Enrollment Period (Jan 1–Mar 31 for MA plans), or certain Special Enrollment Periods. After disenrolling from MA, you return to Original Medicare.

Durable Medical Equipment (DME) Part B

Equipment that is medically necessary, expected to last at least 3 years, and used in the home. Medicare Part B covers 80% of the approved amount (after deductible) for DME including wheelchairs, walkers, CPAP machines, hospital beds, and blood glucose monitors when ordered by a Medicare-enrolled doctor.

Dual Eligible General

People who qualify for both Medicare and Medicaid. About 12 million Americans are dual eligible. They may qualify for Extra Help with Part D costs, Special Needs Plans (D-SNPs), and have most Medicare cost sharing covered by Medicaid. This is one of the most comprehensive coverage combinations available.

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E

End-Stage Renal Disease (ESRD) Eligibility

Permanent kidney failure requiring regular dialysis or a kidney transplant. ESRD is one of the pathways to Medicare eligibility before age 65, regardless of work history. There is a waiting period of up to 3 months after dialysis begins before coverage starts (immediately with a transplant in some cases).

Enrollment Period Enrollment

A specific window of time when you can sign up for, change, or drop Medicare coverage. The main enrollment periods are: Initial Enrollment Period (IEP), General Enrollment Period (GEP), Annual Election Period (AEP), Medicare Advantage Open Enrollment Period (MA-OEP), and Special Enrollment Periods (SEPs).

See also: Enrollment Guide

Evidence of Coverage (EOC) Part C

A detailed document from your Medicare Advantage or Part D plan that describes exactly what is covered, what you pay, and the rules of your plan for the upcoming year. Plans must mail the EOC by October 15 each year. You should review it carefully when it arrives to check for benefit changes.

Excluded Services General

Services Medicare does not cover, including routine dental care, routine vision and eyeglasses (except after cataract surgery), routine hearing exams and hearing aids, cosmetic surgery, acupuncture (with limited exceptions), and long-term custodial care. Medicare Advantage plans sometimes fill these gaps voluntarily.

Extra Help (Low-Income Subsidy / LIS) Part D

A federal program that helps people with limited income and resources pay Part D premiums, deductibles, and drug costs. In 2025, Extra Help can be worth over $5,000/year in savings. You may qualify if your income is up to 150% of the federal poverty level. Apply through Social Security or your State Medicaid office.

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F

Formulary (Drug Formulary) Part D

The list of prescription drugs covered by your Part D or Medicare Advantage plan. Drugs are organized into tiers (typically 1–5), with Tier 1 generics costing the least and Tier 5 specialty drugs costing the most. Plans can change their formularies annually, and mid-year changes for covered drugs require 60 days' notice.

Formulary Exception Part D

A request to your Part D plan to cover a drug not on its formulary, or to cover a formulary drug at a lower cost-sharing tier. Your prescriber must provide a supporting statement. Plans must respond to standard exceptions within 72 hours and urgent exceptions within 24 hours.

Free Preventive Services Part B

Medicare Part B covers many preventive services at no cost to you (no deductible or coinsurance) when provided by a participating provider. These include the annual wellness visit, flu/pneumonia/COVID-19 vaccines, mammograms, colonoscopies, cardiovascular screenings, and diabetes prevention programs, among others.

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G

Gap Coverage Medigap

Informal term for Medigap (Medicare Supplement Insurance), which fills the "gaps" in Original Medicare coverage — deductibles, coinsurance, and copays. The most popular gap coverage plan in 2025 is Plan G, which covers all Part A and Part B costs except the Part B deductible.

General Enrollment Period (GEP) Enrollment

January 1–March 31 each year. If you missed your Initial Enrollment Period for Part B (or Part A if you must pay a premium), you can sign up during the GEP. Coverage begins July 1. You may face a late enrollment penalty. Compare with Special Enrollment Periods, which typically have no penalty.

Guaranteed Issue Rights (Medigap) Medigap

Situations where insurance companies must sell you a Medigap policy without medical underwriting (i.e., they can't deny you or charge more due to health conditions). These rights are triggered by events like losing employer coverage, your plan leaving Medicare, or moving out of a plan's service area.

See also: Medigap Guide

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H

Health Maintenance Organization (HMO) Part C

The most common Medicare Advantage plan type. HMOs require you to use doctors and hospitals in the plan's network, choose a primary care physician (PCP), and get referrals to see specialists. Out-of-network care is generally not covered except in emergencies. HMOs typically have lower premiums than PPOs.

Home Health Care Part A / B

Part-time or intermittent skilled nursing care, physical therapy, speech-language pathology, and related services provided at home. Medicare covers home health care if you are homebound and a doctor certifies you need skilled care. There's no cost to you for covered services (no deductible or coinsurance for home health). Medicare does NOT cover 24-hour home care.

Hospice Care Part A

Comfort-focused care for people who are terminally ill with a life expectancy of 6 months or less. Medicare covers hospice care provided by a Medicare-approved hospice program. You can receive most care at home. There's a small copay for outpatient drugs and respite care but most hospice services are covered at 100%.

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I

Initial Coverage Limit (Part D) Part D

The total drug spending threshold that used to trigger the coverage gap (donut hole). Starting in 2025, the donut hole is effectively eliminated. You now pay 25% of drug costs from the deductible through the $2,000 out-of-pocket cap, regardless of total spending thresholds.

Initial Enrollment Period (IEP) Enrollment

A 7-month window centered on your 65th birthday month to enroll in Medicare. It includes the 3 months before your birthday month, your birthday month, and the 3 months after. Enrolling in the first 3 months of your IEP gives you the earliest possible coverage start date. Missing your IEP can result in late enrollment penalties.

See also: Enrollment Guide

Inpatient Status Part A

When a doctor formally admits you to a hospital with a written order and a physician approves your admission. Only inpatient hospital stays trigger Part A benefits. The distinction between inpatient and observation status (outpatient) significantly affects your costs and eligibility for follow-up skilled nursing facility coverage.

IRMAA (Income-Related Monthly Adjustment Amount) Part B / D

A surcharge added to your Part B and/or Part D premiums if your income exceeds certain thresholds. Based on your tax return from 2 years prior. In 2025, IRMAA applies to individuals with income above $106,000 (single) or $212,000 (married filing jointly). The highest tier adds $443.90/month to your Part B premium alone.

See also: Part B IRMAA table

Issue-Age Rating Medigap

A Medigap pricing method where your premium is based on your age when you buy the policy and never increases because of age alone (though it can increase due to inflation and other factors). Policies bought at age 65 will have lower starting premiums than those bought later, but premiums don't escalate annually with your age.

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L

Late Enrollment Penalty (LEP) Enrollment

A permanent premium surcharge for people who didn't enroll in Part B or Part D when first eligible (and didn't have qualifying coverage). Part B penalty: 10% per 12-month period you delayed. Part D penalty: 1% of the national base beneficiary premium per month you went without creditable coverage. These penalties typically last for life.

Lifetime Reserve Days Part A

An additional 60 inpatient hospital days Medicare provides beyond the standard 90 days covered per benefit period. You have exactly 60 lifetime reserve days total — once used, they're gone permanently. In 2025, each lifetime reserve day costs $838 in coinsurance.

Limiting Charge Part B

The maximum amount a non-participating provider (one who doesn't accept Medicare assignment) can charge you. Currently set at 115% of the Medicare-approved amount. This means you could pay up to 15% more than Medicare's rate with such providers. Some states ban excess charges entirely.

Low-Income Subsidy (LIS) Part D

Another name for the Extra Help program that reduces Part D costs for people with limited income. See Extra Help.

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M

M3P (Medicare Prescription Payment Plan) Part D

A new 2025 option that lets you spread your out-of-pocket Part D drug costs across monthly installments throughout the year, rather than paying large amounts at once. This doesn't reduce what you owe — it just smooths the payments. You must opt in each year through your plan.

Medicaid General

A joint federal-state program providing health coverage for people with very low income. Different from Medicare — Medicaid is income-based while Medicare is primarily age-based. Some people qualify for both (dual eligibles). Medicaid can cover Medicare premiums, cost sharing, and long-term care that Medicare doesn't cover.

Medicare Advantage (Part C) Part C

Medicare coverage delivered by private insurance companies approved by Medicare. MA plans must cover everything Original Medicare covers but usually offer additional benefits (dental, vision, hearing). They use provider networks and have an annual out-of-pocket maximum ($9,350 in-network for 2025). Over 33 million people — about half of all Medicare enrollees — are in MA plans.

See also: Medicare Advantage Guide

Medicare Advantage Open Enrollment Period (MA-OEP) Part C

January 1–March 31 each year. If you're enrolled in a Medicare Advantage plan, you can switch to a different MA plan or return to Original Medicare (and join a Part D plan). You can only make one change during this period.

Medicare-Approved Amount Part B

The fee Medicare has set as the maximum it will pay for a specific service or item. For participating providers, this is the total payment (Medicare pays 80%, you pay 20%). For non-participating providers, the limiting charge applies. For out-of-network MA services, the plan's own fee schedule applies.

Medicare Part A (Hospital Coverage) Part A

The part of Original Medicare that covers inpatient hospital care, skilled nursing facility (SNF) care following hospitalization, hospice care, and some home health care. Most people don't pay a premium for Part A if they or their spouse worked and paid Medicare taxes for at least 10 years (40 quarters).

See also: Hospital Coverage Guide

Medicare Part B (Medical Coverage) Part B

The part of Original Medicare that covers outpatient services including doctor visits, preventive care, outpatient surgery, medical equipment, and some home health care. The standard Part B premium is $185/month in 2025, with a $257 annual deductible and typically 20% coinsurance.

See also: Medical Coverage Guide

Medicare Part D (Prescription Drug Coverage) Part D

Optional Medicare coverage for prescription drugs, available as a standalone Prescription Drug Plan (PDP) or built into a Medicare Advantage plan (MAPD). In 2025, the out-of-pocket cap is $2,000 — a new consumer protection. You must enroll when first eligible or face late enrollment penalties.

See also: Prescription Coverage Guide

Medicare Savings Programs (MSPs) General

State programs that help people with limited income and resources pay some Medicare costs. The four types are: Qualified Medicare Beneficiary (QMB) — pays Part A/B premiums and cost sharing; Specified Low-Income Medicare Beneficiary (SLMB) — pays Part B premium; Qualifying Individual (QI) — partial Part B premium; and Qualified Disabled and Working Individuals (QDWI). Contact your State Medicaid office to apply.

Medicare Summary Notice (MSN) General

A statement Medicare sends every 3 months showing services billed to Medicare on your behalf, what Medicare paid, and what you may owe. Similar to an Explanation of Benefits (EOB). Review it carefully for errors or potential fraud, and keep it for your records.

Medigap (Medicare Supplement Insurance) Medigap

Private insurance that supplements Original Medicare by paying some or all of the costs Original Medicare doesn't cover — primarily the Part A and Part B deductibles, coinsurance, and copays. Sold by letter (Plan A, B, D, G, K, L, M, N). Plans C and F are no longer available to people who became eligible after January 1, 2020.

See also: Medigap Guide

MOOP (Maximum Out-of-Pocket) Part C

The annual cap on what you pay out-of-pocket for covered services in a Medicare Advantage plan. In 2025, the federal limit is $9,350 for in-network services ($14,000 combined in/out-of-network). After reaching this cap, the plan pays 100% of covered costs for the rest of the year. Original Medicare has no MOOP.

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N

Network (Provider Network) Part C

The group of doctors, hospitals, and other health care providers that have contracted with a Medicare Advantage plan to provide services at negotiated rates. Seeing in-network providers typically costs less. HMO networks are usually restrictive; PPO networks are broader. Original Medicare has no network — you can see any provider who accepts Medicare.

Non-Covered Services General

Health services that Medicare doesn't pay for, including most dental care, routine eye exams and glasses, hearing aids, cosmetic procedures, acupuncture (with limited exceptions), long-term custodial care, and care received outside the U.S. (with limited exceptions). Understanding these gaps helps you plan for additional coverage needs.

Notice of Medicare Non-Coverage (NOMNC) General

A written notice you must receive at least 2 days before a Medicare-covered service ends (such as home health, hospice, or skilled nursing care). It tells you when coverage will end and your right to appeal. Request a fast appeal by noon the day before the effective date to have coverage continue while your appeal is reviewed.

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O

Observation Stay Part A / B

When you're placed in a hospital under "observation status" rather than admitted as an inpatient. This is billed as outpatient (Part B), not inpatient (Part A), which can dramatically increase your out-of-pocket costs and may disqualify you from Medicare-covered skilled nursing facility care afterward. Always ask your hospital about your admission status.

Open Enrollment Period (Medicare) Enrollment

See Annual Election Period (AEP) — October 15 to December 7 each year.

Original Medicare General

The traditional Medicare program run directly by the federal government, consisting of Part A (hospital) and Part B (medical). It's a fee-for-service program meaning Medicare pays providers directly for each service. You can see any doctor or hospital that accepts Medicare nationwide with no referrals needed. There's no annual out-of-pocket cap.

Out-of-Pocket Costs General

Expenses you pay yourself for health care services, including deductibles, copays, coinsurance, and premiums. Medicare Advantage plans have an annual out-of-pocket maximum. Original Medicare has no cap, which is why many people buy Medigap policies to protect against catastrophic costs.

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P

Part D Late Enrollment Penalty Part D

A permanent premium increase for going without Part D or creditable prescription drug coverage for 63 or more consecutive days after your Initial Enrollment Period. The penalty is calculated as 1% × months without coverage × national base beneficiary premium ($36.78 in 2025). It's added to your monthly premium for as long as you have Part D coverage.

PDP (Prescription Drug Plan) Part D

A standalone Medicare Part D plan that adds prescription drug coverage to Original Medicare. PDPs are sold by private insurers and vary in premiums, deductibles, formularies, and pharmacy networks. You need a PDP if you have Original Medicare and want drug coverage; if you have Medicare Advantage, you usually get drug coverage through that plan (MAPD) instead.

PPO (Preferred Provider Organization) Part C

A type of Medicare Advantage plan with more flexibility than an HMO. You can see out-of-network providers (at higher cost), don't need referrals to see specialists, and don't need to choose a primary care physician. PPO plans typically have higher premiums but more provider choice. They're the second most common type of Medicare Advantage plan.

Premium General

The monthly amount you pay for Medicare coverage, regardless of whether you use any health services. In 2025: Part A is $0 for most people; Part B standard premium is $185/month; Part D premiums vary by plan. Medicare Advantage plans may have $0 premiums (though you still pay Part B). IRMAA surcharges apply to high earners.

Preventive Services Part B

Health care services focused on preventing illness or detecting it early. Medicare Part B covers a broad range of preventive services at no cost to you when provided by a participating provider, including annual wellness visits, cancer screenings, cardiovascular screenings, depression screenings, and vaccinations.

Primary Care Physician (PCP) Part C

A doctor who manages your overall health care — typically a family doctor, internist, or geriatrician. HMO-type Medicare Advantage plans usually require you to choose a PCP and get referrals from them to see specialists. Original Medicare and PPO plans don't require a PCP.

Prior Authorization Part C

Approval from your Medicare Advantage plan required before you receive certain services, procedures, or medications. Original Medicare generally does not require prior authorization for covered services. Prior authorization is a common concern with MA plans — CMS has introduced rules to speed up the authorization process.

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R

Referral Part C

A written order from your primary care physician authorizing you to see a specialist or receive certain medical services. HMO-type Medicare Advantage plans typically require referrals; PPO plans generally do not. Original Medicare never requires referrals.

Retiree Coverage General

Health insurance some employers provide to former employees after retirement. Retiree coverage usually works alongside Medicare — Medicare pays first, retiree coverage pays second. Retiree drug coverage is often creditable, allowing you to delay Part D enrollment without penalty. Always verify the creditable status annually.

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S

Special Enrollment Period (SEP) Enrollment

A period outside the standard enrollment windows when you can make certain Medicare changes due to a qualifying life event. Common SEP triggers include losing employer coverage, moving, gaining Extra Help, or having a plan leave your area. SEPs generally allow enrollment without late penalties. Timing and rules vary by SEP type.

See also: Enrollment Guide

SHIP (State Health Insurance Assistance Program) General

A free, unbiased Medicare counseling program in every state, funded by the federal government but run locally. SHIP counselors are trained volunteers and staff who can help you understand your options, compare plans, file appeals, and apply for assistance programs — without trying to sell you anything. Find your local SHIP at shiphelp.org.

Skilled Nursing Facility (SNF) Part A

A facility providing short-term skilled care (nursing, physical therapy, occupational therapy, speech therapy) after a qualifying hospital stay. Medicare Part A covers SNF care for up to 100 days per benefit period: days 1–20 are fully covered; days 21–100 require a $209.50/day copay in 2025; day 101+ are not covered. A 3-day qualifying hospital inpatient stay (not observation) is required.

See also: Hospital Coverage Guide

SNP (Special Needs Plan) Part C

A type of Medicare Advantage plan designed for specific groups: Dual-Eligible SNPs (D-SNPs) for people with both Medicare and Medicaid; Chronic Condition SNPs (C-SNPs) for people with specific chronic conditions; and Institutional SNPs (I-SNPs) for people in nursing facilities. SNPs tailor benefits to their target population.

Social Security Administration (SSA) General

The federal agency that handles Medicare enrollment and Part B premium collection. You can enroll in Medicare through SSA (online at ssa.gov, by phone at 1-800-772-1213, or in person at a local SSA office). If you're already receiving Social Security benefits at 65, you're typically enrolled in Medicare Parts A and B automatically.

Star Ratings (CMS) Part C / D

A 1–5 star quality rating system CMS uses to evaluate Medicare Advantage and Part D plans based on measures like customer service, member complaints, preventive care screenings, drug safety, and plan management. Plans rated 4–5 stars qualify for bonus payments. You can see star ratings at Medicare.gov/plan-compare. 5-star plans have year-round enrollment.

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T

Tier (Drug Formulary) Part D

The cost level assigned to a drug in a formulary. Most Part D plans use 5 tiers: Tier 1 (preferred generics, lowest cost), Tier 2 (non-preferred generics), Tier 3 (preferred brand-name drugs), Tier 4 (non-preferred brands), Tier 5 (specialty drugs, highest cost). Your copay or coinsurance depends on which tier your drug is in.

TRICARE / VA Coverage General

Health coverage for military retirees (TRICARE) and veterans (VA). Both can work alongside Medicare. VA coverage is considered creditable for Part D, so veterans with VA drug benefits generally don't face late enrollment penalties. TRICARE for Life requires Medicare Part B enrollment and works as secondary coverage.

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V

Voluntary Termination of Coverage General

Choosing to drop a Medicare Advantage or Part D plan. You can do this during applicable enrollment periods. Be cautious about dropping Medigap coverage — you may not be able to get it back at the same price due to medical underwriting. And dropping Part B is generally permanent and can affect future coverage.

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W

Wellness Visit (Annual) Part B

A yearly visit covered at 100% (no cost to you) to develop or update a personalized prevention plan based on your current health and risk factors. Different from a "physical" — it's focused on prevention planning, not a comprehensive physical exam. Medicare also covers a one-time "Welcome to Medicare" preventive visit in your first 12 months of Part B.

Working Past 65 (Active Employer Coverage) Enrollment

If you or your spouse is still working at 65 and you're covered by employer insurance from that job, you can delay Medicare enrollment without penalty. Your employer coverage acts as primary insurance. When that job ends, you have an 8-month SEP to enroll in Part B without a late penalty. COBRA does NOT count as active employer coverage for this purpose.

See also: Enrollment Guide

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