Premium
The amount you pay regularly to keep coverage, usually each month.
Medicare definitions
Translate common Medicare terms.
Use this glossary when plan documents or conversations include an unfamiliar word. Definitions are simplified and do not replace official plan terms.
Deductible
The amount you may need to pay for covered care or drugs before the plan begins paying its share.
Copay
A fixed amount you pay for a covered service or prescription.
Coinsurance
A percentage of the allowed cost you pay for a covered service or prescription.
Formulary
A health plan's list of covered prescription drugs, often organized into cost tiers.
Network
The doctors, hospitals, pharmacies, and other providers that contract with a plan.
HMO
A plan type that generally uses a provider network and may require referrals or a primary care provider.
PPO
A plan type with a preferred network that may allow out-of-network care at a higher cost.
Part A
The part of Original Medicare that generally covers inpatient hospital care and certain related services.
Part B
The part of Original Medicare that generally covers outpatient medical and preventive services.
Part C
Another name for Medicare Advantage, offered by private insurers approved by Medicare.
Part D
Medicare coverage for outpatient prescription drugs through private plans.
Medigap
Private supplemental insurance that helps with certain out-of-pocket costs in Original Medicare.
Annual Enrollment Period
The October 15 through December 7 period when people can generally change Medicare Advantage or Part D coverage.
Initial Enrollment Period
For many people, the seven-month window around their 65th birthday when they can first enroll in Medicare.
Special Enrollment Period
A limited opportunity to enroll or change coverage after certain qualifying events.
Keep in mind: Plan availability, benefits, costs, and enrollment rules can vary by location and personal situation. Planwise65 helps organize your comparison and can connect you with licensed agent support.
Plans are local
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See available Medicare plans in your area, then organize the details that matter to you.