We understand that navigating the world of medical insurance can be daunting and overwhelming. With so many different terms and jargon to sift through, it's easy to feel confused and frustrated. That's why we've created a glossary of terms to help you understand the ins and outs of medical insurance.
Our glossary is a handy tool that breaks down complex terminology into simple, easy-to-understand definitions. Whether you're a seasoned insurance pro or a newcomer to the world of medical insurance, our glossary can help you make sense of it all.
So why not take a few moments to scroll through our list of terms and learn about things you might not otherwise look for? We promise you'll find it useful and informative!
Click a letter or scroll through the terms! Select 'Reset' to clear the selected letter.
Annual Election Period from October 15th thru December 7th.
A form of insurance or investment entitling the investor to a series of annual sums.
Cancer Stroke & Heart Attack insurance policies are health insurance policies that provide a lump sum benefit in the event that the policyholder is diagnosed with cancer, has a heart attack, or suffers a stroke. The benefit can be used to cover medical expenses, such as hospital stays, treatment, and medication.
Dental benefit embedded in some Medicare Advantage plans or stand-alone dental plans.
Dental, Vision and Hearing insurance is designed to meet as many needs outside of standard medical insurance as possible. It provides coverage at the dentist as well as vision and hearing benefits for things like contact lenses, hearing aids, eye exams, and more.
Third stage found in all Prescription Drug Plans and Medicare Advantage Prescription Drug plans. Once in this stage, there is a temporary limit on what the drug plan will pay for drugs.
No cost gym membership included in either MAPD or Medigap plans.
A list of the different medications that each PDP and MAPD offers. Not all formularies are the same.
Hearing Aid benefit embedded in some Medicare Advantage Plans.
Health Maintenance Organization. A type of health insurance plan that usually limits coverage to a network of providers who work for or contract with the HMO.
Private insurance plan that may provide a cash payment to a beneficiary in the event of a hospitalization, use of ambulance, or stay at a skilled nursing facility. The cash payment can be used any way the beneficiary decides.
Income Related-Monthly Adjusted Amount. A surcharge that people with income above a certain amount must pay in addition to their Medicare Part B and Part D premium.
A dollar amount that is permanently added to either a PDP premium and or Medicare Part B premium.
Chris will tell you that it’s a product of love but the formal definition is a contract between a life insurance company and a policy owner. A life insurance policy guarantees the insurer pays a sum of money to one or more named beneficiaries when the insured person dies in exchange for premiums paid by the policyholder during their lifetime.
Medicare Advantage plan, also known as Medicare Part C, is a Medicare Advantage plan that does not include Medicare Part D drug coverage.
Medicare Advantage Prescription Drug, also known as Part C, is a Medicare Advantage plan that includes Medicare Part D drug coverage.
The same as Medicare Advantage without Prescription Drug coverage included.
MAPD, also known as Medicare Part C, is a type of Medicare health plan offered by Medicare-approved private companies that must follow rules set by Medicare. A beneficiary must have Medicare Parts A & B to enroll into a MAPD plan.
Part A is the portion of Original Medicare that pertains to hospital insurance. It covers inpatient hospital stays, skilled nursing care, hospice care, and limited home healthcare services.
Part B is the portion of Original Medicare that covers medical services and supplies that are medically necessary to treat health conditions. This can include outpatient care, preventative services, ambulance services, and durable medical equipment.
Another name for Part C is Medicare Advantage. Part C plans are a type of Medicare health plan offered by Medicare-approved private companies that must follow rules set by Medicare. A beneficiary must have Medicare Parts A & B to enroll into a MAPD plan.
Prescription drug coverage. Both MAPD plans and PDPs are types of Part D Plans.
A Medicare Supplement Insurance plan (also called Medigap) can help cover some of the out-of-pocket costs that Original Medicare doesn’t, such as copays and deductibles. Each type of plan offers a different combination of basic health insurance benefits.
Medicare Supplement Insurance that helps fill “gaps” in Original Medicare and is sold by private companies.
Group of healthcare professionals and services that are contracted with an HMO. Networks can be comprised of doctors, hospitals, lab facilities and more.
Over The Counter benefit embedded in some Medicare Advantage Plans.
Prescription Drug Plan. There are stand alone PDPs or some are bundled with Medicare Advantage plans to form MAPD plans.
Preferred Provider Organization is defined as a type of managed care health insurance plan that provides maximum benefits if you visit an in-network physician or provider, but still provides some coverage for out-of-network providers.
Another name for a prescription drug.
Senior Insurance Consultants.
Eye Glass or Contact Lens benefit embedded in some MAPD plans or stand-alone plans.