Medicare

A federal health insurance program in the United States that provides coverage to people aged 65 and older, younger people with disabilities, and those with end-stage renal disease (ESRD).

 

Part A

Medicare Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care services.

 

Part B

Medicare Part B covers outpatient care, physician services, preventive services, durable medical equipment (DME), and some home health care services.

 

Part C (Medicare Advantage)

Also known as Medicare Advantage, Part C plans are offered by private insurance companies approved by Medicare. These plans typically include coverage for Parts A and B services and may offer additional benefits like prescription drug coverage and dental or vision services.

 

Part D

Medicare Part D is a prescription drug benefit program that helps cover the cost of prescription medications. Part D plans are offered by private insurance companies approved by Medicare.

 

Medigap (Medicare Supplement Insurance)

Medigap policies are private insurance plans that help cover some of the out-of-pocket costs associated with Original Medicare (Parts A and B), such as copayments, coinsurance, and deductibles.

 

CMS (Centers for Medicare & Medicaid Services)

The federal agency within the U.S. Department of Health and Human Services responsible for administering the Medicare program and overseeing state Medicaid programs.

 

Dual Eligible

Individuals who are eligible for both Medicare and Medicaid benefits. Dual eligible beneficiaries often have low incomes and may receive assistance with Medicare premiums, cost-sharing, and additional benefits through Medicaid.

 

Medicare Savings Program

State-run programs that help low-income Medicare beneficiaries pay for Medicare premiums, deductibles, coinsurance, and copayments.

 

Open Enrollment Periods

Designated times when Medicare beneficiaries can make changes to their coverage, such as switching between Original Medicare and Medicare Advantage plans, or changing prescription drug coverage.