Common Definitions in Medicare and Supplemental Insurance

By Ed Crowe | General Articles | 0 comment | 7 May, 2023 | 0

Common Definitions in Medicare and Supplemental Insurance

The jargon around Medicare and insurance in general can feel very inaccessible to potential clients. One of the ways that agents can earn the trust of those clients as well as inform them and help them find coverage that works for them is to know the common definitions in Medicare and Supplemental insurance.

The following are some of the common Medicare-related terms that clients will need to know:

Annual Election Period (AEP):

This is the period of time during which people can enroll in, disenroll from, or change their Medicare Advantage, Supplemental plans or prescription drug plans. This is also the period of time in which beneficiaries can return to original Medicare. Choices made during this time period are effective January 1st of the following year. The time period is October 15th to December 7th.

Coverage Gap or Donut Hole:

Not every beneficiary will reach this gap. However, the coverage gap for 2023 begins after the beneficiary and their drug plan have spent $4660 dollars on covered and approved medications. While in this coverage gap, members with higher prescription drug costs will pay a higher percentage of the cost of their medicine.

Deductible:

This is the amount that beneficiaries will pay for benefits before the plan begins to pay for their benefits. These include medical coverage, including services, prescriptions, and products.

Initial Coverage Election Period:

This is often referred to by its acronym, the ICEP. This is the period of time when a person who is eligible for Medicare can sign up to receive those benefits for the first time. It begins three months before the person’s birthday month, includes the birthday month, and ends three months after the birthday month. It is a seven month period.

Medicaid: It is easy to get confused between Medicare and Medicaid. Medicaid is a program that provides health-coverage for certain low-income people. Most often included are pregnant women, the elderly, and those with disabilities. It is funded jointly by federal and state money.