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Medicare Glossary

Understand Medicare terms, jargon, and acronyms in plain language

Medicare can be confusing — especially with all the acronyms, plan names, and technical terms. Our Medicare Glossary breaks down the most common terms you’ll encounter, so you can make informed decisions with confidence.

This page is your go-to reference for definitions, explanations, and quick clarifications.

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A – C

Annual Enrollment Period (AEP)

– The yearly window (October 15 – December 7) when you can review, change, or switch Medicare plans.

Coinsurance

– The percentage of a medical bill you pay after meeting your deductible.

Copayment (Copay)

– A fixed amount you pay for a covered service, such as a doctor visit or prescription.

Creditable Coverage

– Employer or other health coverage that is at least as good as Medicare Part D, allowing you to delay Part D without penalty.

D – F

Deductible

– The amount you must pay out-of-pocket before Medicare (or your plan) begins to pay for services.

Durable Medical Equipment (DME)

– Medical equipment prescribed by a doctor, such as wheelchairs, walkers, or oxygen supplies.

Drug Formulary

– A list of prescription medications covered by a specific Medicare Part D or Medicare Advantage plan.

H – M

Health Maintenance Organization (HMO)

– A type of Medicare Advantage plan with a network of doctors and hospitals you must use to receive coverage, except in emergencies.

Initial Enrollment Period (IEP)

– The first window of time when you can enroll in Medicare, typically around your 65th birthday.

Medicare Advantage (Part C)

– Private insurance plans that combine Part A and Part B coverage, and often include Part D (prescription drugs) and extra benefits.

Medigap (Medicare Supplement Insurance)

– A private insurance policy that works alongside Original Medicare to help pay deductibles, coinsurance, and copayments.

P – R

Part A

– Hospital insurance that covers inpatient care, skilled nursing facility stays, and hospice.

Part B

– Medical insurance that covers doctor visits, outpatient services, preventive care, and some medical equipment.

Part D

– Prescription drug coverage that can be purchased standalone or included in Medicare Advantage plans.

Premium

– The monthly payment you make for Medicare coverage or a Medicare plan.

Prescription Drug Plan (PDP)

– A standalone plan that covers prescription medications under Medicare Part D.

S – Z

Special Enrollment Period (SEP)

– A period outside standard enrollment windows that allows you to enroll, change, or drop coverage due to qualifying life events.

Skilled Nursing Facility (SNF)

– A facility that provides short-term rehabilitative care after hospitalization.

Out-of-Pocket Maximum

– The most you’ll pay in a year for covered services in certain plans, like Medicare Advantage.

IRMAA (Income-Related Monthly Adjustment Amount)

– Extra charges for Part B or D premiums for individuals with higher income.

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Get Help Understanding Medicare Terms

Even with a glossary, some terms may still feel confusing. Personalized guidance can help.

Get clear explanations in plain language
Learn how terms affect your coverage and costs
Ask a Medicare specialist your questions

At *Retire With Medicare**, we help you navigate the system with* confidence and clarity.

Shelton, Connecticut / Glastonbury, Connecticut

Mon-Fri 8:30 am - 7:00 pm, Sat: 8:30 - 12:30 Sun: Closed

[email protected]

CMS Disclaimer: 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. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.

Medicare Glossary

A – C

Annual Enrollment Period (AEP)

– The yearly window (October 15 – December 7) when you can review, change, or switch Medicare plans.

Coinsurance

– The percentage of a medical bill you pay after meeting your deductible.

Copayment (Copay)

– A fixed amount you pay for a covered service, such as a doctor visit or prescription.

Creditable Coverage

– Employer or other health coverage that is at least as good as Medicare Part D, allowing you to delay Part D without penalty.

D – F

Deductible

– The amount you must pay out-of-pocket before Medicare (or your plan) begins to pay for services.

Durable Medical Equipment (DME)

– Medical equipment prescribed by a doctor, such as wheelchairs, walkers, or oxygen supplies.

Drug Formulary

– A list of prescription medications covered by a specific Medicare Part D or Medicare Advantage plan.

H – M

Health Maintenance Organization (HMO)

– A type of Medicare Advantage plan with a network of doctors and hospitals you must use to receive coverage, except in emergencies.

Initial Enrollment Period (IEP)

– The first window of time when you can enroll in Medicare, typically around your 65th birthday.

Medicare Advantage (Part C)

– Private insurance plans that combine Part A and Part B coverage, and often include Part D (prescription drugs) and extra benefits.

Medigap (Medicare Supplement Insurance)

– A private insurance policy that works alongside Original Medicare to help pay deductibles, coinsurance, and copayments.

P – R

Part A

– Hospital insurance that covers inpatient care, skilled nursing facility stays, and hospice.

Part B

– Medical insurance that covers doctor visits, outpatient services, preventive care, and some medical equipment.

Part D

– Prescription drug coverage that can be purchased standalone or included in Medicare Advantage plans.

Premium

– The monthly payment you make for Medicare coverage or a Medicare plan.

Prescription Drug Plan (PDP)

– A standalone plan that covers prescription medications under Medicare Part D.

S – Z

Special Enrollment Period (SEP)

– A period outside standard enrollment windows that allows you to enroll, change, or drop coverage due to qualifying life events.

Skilled Nursing Facility (SNF)

– A facility that provides short-term rehabilitative care after hospitalization.

Out-of-Pocket Maximum

– The most you’ll pay in a year for covered services in certain plans, like Medicare Advantage.

IRMAA (Income-Related Monthly Adjustment Amount)

– Extra charges for Part B or D premiums for individuals with higher income.

Providing Excellent & Expert TherapyService According To Need

Lorem ipsum dolor sit amet, consectetur adipiscing elit.

Lorem ipsum dolor sit amet, consectetur adipiscing elit.

Lorem ipsum dolor sit amet, consectetur adipiscing elit.

Get Help Understanding Medicare Terms

At Retire With Medicare, we help you navigate the system with confidence and clarity.

CMS Disclaimer: 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. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.

Providing Excellent & Expert Therapy
Service According To Need

At *Retire With Medicare**, we help you navigate the system with* confidence and clarity.