Benefit Period - The length of time the Part D Medicare Prescription Drug Plan is in effect and the individual who has joined has access to all the services, discounts, and coverage associated with the Plan. The maximum benefit period will run January 1 through December 31 of each year. Individuals who enroll in a Medicare Prescription Drug Plan after January 1 (for instance, those who become eligible for Medicare midyear) will have a benefit period that begins the first day of the month after the month they enrolled and will run through December 31 of that calendar year.

Carrier - A private company that contracts with Medicare to pay Part B bills.

Coinsurance - The amount you may be required to pay for each medical service, like a doctor's visit or a prescription, after you pay any plan deductibles. Coinsurance is usually a percentage of the bill. For example, this could be 20% of the cost of the prescription.

Copayment - The amount you may be required to pay for each medical service, like a doctor's visit or a prescription, after you pay any plan deductibles. A copayment is usually a set amount you pay. For example, this could be $20 for a prescription.

Coverage Limits - Some insurance will limit the amount of coverage it will provide. You will be responsible for any costs above that limit. The Medicare Prescription Drug Coverage does not have a limit; if your drug expenses are more than $3600 of costs paid by you, the plan will pay nearly all of your drug expenses until the end of the year, with no upper limit. In this step, you pay only a small share of your drug expenses (approximately five percent).

Coverage Gap - Some Medicare Prescription Drug Plans will have a step in their coverage benefit in which you will be responsible for all or almost all of the costs of your prescriptions. This is also known as a 'doughnut hole'. Not all plans will have coverage gaps.

Covered Medications List (CML) - This is the same as a Formulary.

Creditable Prescription Drug Coverage - Creditable prescription drug coverage is coverage that is, on average, at least as good as the Medicare standard prescription drug coverage. Drug coverage through an employer or union may qualify as creditable prescription drug coverage.

Deductible - The amount you must pay for prescriptions, before the prescription drug plan or other insurance begins to pay in each benefit period. The deductible for the Medicare prescription drug coverage is calculated on an annual basis. These amounts can change every year.

Formulary - A list of certain kinds of prescription drugs that a Medicare drug plan will cover. This coverage can be subject to limits and conditions.

Health Maintenance Organization (HMO) - An HMO is a type of Medicare Advantage Plan that is available in some areas of the country. Plans must cover all Medicare Part A and Part B healthcare. Some HMOs cover extra benefits, like extra days in the hospital. In most HMOs, you can only go to doctors, specialists or hospitals on the plan's list except in an emergency. Many HMOs will also cover prescription drugs. Your costs may be lower than in the Original Medicare plan.

Institution - A facility that meets Medicare's definition of a long term care facility, such as a nursing home or skilled nursing facility. It doesn't include assisted living facilities or residential homes.

Long-term Care - A variety of services that help people with health or personal needs and activities of daily living over a period of time. Long-term care can be provided at home, in the community, or in various types of facilities, including nursing homes and assisted living facilities. Most long-term care is custodial care. Medicare doesn't pay for this type of care if this is the only kind of care you need.

Medicaid - A joint Federal and State program that helps with medical costs for some people with low incomes and limited resources. Medicaid programs vary from state to state, but most health care costs are covered if you qualify for both Medicare and Medicaid.

Medicare Advantage Plan - A plan offered by a private company that contracts with Medicare to provide you with all your Medicare Part A and Part B benefits. In most cases, Medicare Advantage Plans also offer Medicare prescription drug coverage. A Medicare Plan can be a Heatlh Maintenance Organization (HMO), a Preferred Provider Organization (PPO), or a Private Fee-for-service Plan (PFFS). Your costs may be lower in a Medicare Advantage Plan than in Original Medicare.

Medicare Cost Plan-A Medicare Cost Plan is a type of HMO. In a Medicare Cost Plan, if you get services outside of the plan's network without a referral, your Medicare-covered services will be paid for under the Original Medicare plan.

Medicare Health Plan-A Medicare Advantage plan (such as an HMO, PPO or PFFS) or other plan such as a Medicare Cost Plan. Everyone who has Medicare Part A and Part B is eligible for a plan in their area, except those with End Stage Renal Disease (unless certain exceptions apply). Your costs may be lower in a Medicare Health Plan than in Original Medicare.

Medicare Prescription Drug Plan- A stand-alone drug plan, offered by insurance and other private companies that adds prescription drug coverage to the Original Medicare Plan, to Medicare Private Fee-for-service (PFFS) plans that don't have prescription drug coverage, and to Medicare Cost Plans.

Medigap Policy - A Medicare supplement insurance policy sold by private insurance companies to fill "gaps" in Original Medicare Plan coverage. Except in Massachusetts, Minnesota, and Wisconsin, there are 12 standardized plans labeled Plan A through Plan L. Medigap policies only work with the Original Medicare Plan.

Original Medicare Plan - A fee-for-service health plan that lets you go to any doctor, hospital, or other health care supplier who accepts Medicare and is accepting new Medicare patients. You must pay the deductible. Medicare pays its share of the Medicare-approved amount and you pay your share (coinsurance). In some cases you may be charged more than the Medicare-approved amount. The Original Medicare Plan has two parts: Part A (Hospital Insurance) and Part B (Medical Insurance). Drug coverage is available through Medicare Prescription Drug Plans for people in Original Medicare.

Outpatient Care - Medical or surgical care that doesn't include an overnight hospital stay.

Penalty- An amount added to your monthly premium for Medicare Part B or for a Medicare prescription drug plan if you don't join when you are first eligible. You pay this amount as long as you have Medicare. There are some exceptions. For instance, you will not pay a penalty if you have Creditable prescription drug coverage and do not enroll in a Prescription Drug Plan until later.

Point-of-Service (POS) - A Medicare Managed Care Plan option that lets you use doctors and hospitals outside the plan for an additional cost.

Preferred Provider Organization (PPO) Plan - A type of Medicare Advantage Plan in which you pay less if you use doctors, hospitals, and providers that belong to the network. You can use doctors, hospitals, and providers outside of the network for an additional cost.

Premium - The periodic payment to Medicare, an insurance company, or a health care plan for health care or prescription drug coverage. The premium for Medicare prescription drug coverage is paid on a monthly basis.

Preventive Services - Health care to keep you healthy or to prevent illness (for example, Pap tests, pelvic exams, flu shots, and screening mammograms).

Primary Care Doctor - A doctor who is trained to give you basic care. Your primary care doctor is the doctor you see first for most health problems. He or she may talk with other doctors and health care providers about your care and refer you to them. In many Medicare Managed Care Plans, you must see your primary care doctor before you can see any other health care provider.

Private Fee-for-Service Plan - A type of Medicare Advantage Plan in which you may go to any Medicare-approved doctor or hospital that accepts the plan's payment. The insurance plan, rather than the Medicare program, decides how much it will pay and what you pay for the services you get. You may pay more or less for Medicare-covered benefits. You may have extra benefits the Original Medicare Plan doesn't cover.

Quality - Quality of care is how well the health plan keeps its members healthy or treats them when they are sick. Good quality health care means doing the right thing at the right time, in the right way, for the right person—and getting the best possible results.

Quality Improvement Organization - Groups of practicing doctors and other health care experts. They are paid by the federal government to check and improve the care given to Medicare patients. They must review your complaints about the quality of care given by: inpatient hospitals, hospital outpatient departments, hospital emergency rooms, skilled nursing facilities, home health agencies, Private Fee-for-Service Plans, and ambulatory surgical centers.

Referral - A written OK from your primary care doctor for you to see a specialist or get certain services. In many Medicare Advantage Plans, you need to get a referral before you can get care from anyone except your primary care doctor. If you don't get a referral first, the plan may not pay for your care.

Skilled Nursing Facility Care - A level of care that requires daily involvement of skilled nursing or rehabilitation staff and that, as a practical matter, can't be provided on an outpatient basis. Examples of skilled nursing facility care include intravenous injections and physical therapy. Needing custodial care, such as help with bathing and dressing, can't, in itself, qualify you for Medicare coverage in a skilled nursing facility. However, if you qualify for skilled nursing or rehabilitation care, Medicare covers all of your care needs in the facility.

Special Needs Plan (SNP) - A type of plan that provides more focused health care for specific groups of people. These plans give you all your Medicare health care as well as more focused care to manage a disease or condition such as congestive heart failure, diabetes, or End-Stage Renal Disease.

State Health Insurance Assistance Program - A State program that gets money from the Federal Government to give free local health insurance counseling to people with Medicare.

Telemedicine - Professional services given to a patient through an interactive telecommunications system by a practitioner at a distant site.

TTY - A teletypewriter (TTY) is a communication device used by people who are deaf, hard of hearing, or have a severe-speech impairment. A TTY consists of a keyboard, display screen, and modem. Messages travel over regular telephone lines. People who don't have a TTY can communicate with a TTY user through a message relay center (MRC). An MRC has TTY operators available to send and interpret TTY messages.