Important Terms
You Should Know

Handles coordination between multiple insurance plans.

Part D plans with low or $0 premiums.

Person receiving Medicare benefits.

Hospital coverage period ending after 60 days without care.

Organization that reviews quality of care and appeals.

Final stage of Part D with low drug costs.

Proof of prior coverage.

Federal regulations collection.

Federal agency administering Medicare/Medicaid.

Percentage paid after deductible (e.g., 20%).

Fixed amount paid per service.

Out-of-pocket costs (copay, coinsurance, deductible).

Prior coverage that meets Medicare standards.

Amount paid before insurance starts paying.

Equipment like wheelchairs or walkers.

Coverage gap in Part D.

Eligible for both Medicare and Medicaid.

Employer-sponsored health insurance.

Kidney failure qualifying for Medicare.

Details of plan benefits and rules.

Fast appeal process.

LIS program helping with drug costs.

Auto enrollment into Part D or LINET.

Regulates drugs and medical products.

List of covered medications.

Income threshold for assistance programs.

Replacing brand drugs with generics.

Complaint about plan services.

Must offer coverage regardless of health.

Policy must be renewed if premiums paid.

Plan requiring network use and referrals.

Care provided at home.

End-of-life care services.

7-month initial Medicare enrollment window.

Hospital or facility care.

Penalty for late enrollment.

Extra hospital days (60 total).

Financial help for drug costs.

State-run health coverage for low income.

Private plans replacing Original Medicare.

Hospital coverage.

Medical/outpatient coverage.

Medicare Advantage plans.

Prescription drug coverage.

Supplement insurance for Medicare gaps.

High-deductible plan with savings account.

Statement of Medicare claims.

Programs helping with Medicare costs.

Non-prescription medications.

Medical care without hospital admission.

Comprehensive care for elderly/disabled.

Primary doctor managing care.

Standalone prescription drug plan.

Plan allowing out-of-network care at higher cost.

Monthly insurance payment.

Services like screenings and vaccines.

Approval required before service.

Pays Part B premium (limited funding).

Program covering Medicare costs for low-income.

Restrictions on drug amounts.

Authorization to see a specialist.

Recovery services (therapy).

Insurance that pays after primary.

Special enrollment period.

Region covered by plan.

Skilled nursing facility.

Social Security Administration.

Disability benefits.

Income support for disabled/elderly.

Drug pricing levels in Part D.

Original Medicare (Part A & B).

Military health insurance.

Out-of-pocket drug costs threshold.

Non-emergency immediate care.

Federal statutory law.

Cost control methods.

Insurance for work injuries.

Extra coverage filling Medicare gaps.