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You are here: Home1 / Our Blog2 / All About Medicare3 / Comparing Medicare options4 / Learning the language of Medicare

Learning the language of Medicare

All About Medicare, Comparing Medicare options, Turning 65?
aspire blog - 11 medicare key terms

Health literacy helps us prevent health problems, protect our health and better manage those problems and unexpected situations that might happen. Reading about Medicare can be like trying to understand a whole new language. However, understanding important Medicare and insurance key terms can boost your health literacy and help you make better decisions about your Medicare coverage.

11 Medicare key terms

  • Co-insurance – the percentage of costs of a covered healthcare service you pay (20 percent, for example) after you’ve paid your deductible.
  • Co-pay – a fixed cost you pay for certain services.
  • Coverage Gap – the period after you’ve reached your Initial Coverage Limit where you have a higher cost share for prescription drugs until you qualify for catastrophic coverage.
  • Deductible – the amount of money you pay before your insurance coverage takes over.
  • Formulary – a list of prescription drugs covered by your Medicare plan.
  • Initial Coverage Limit for prescriptions  Includes the total cost of drugs, including the deductible of what you and your plan pays, before entering the Coverage Gap
  • MOOP – maximum out-of-pocket amount you’ll spend annually for healthcare costs.
  • Out-of-pocket cost – the amount you pay for healthcare services, not counting a monthly premium.
  • Part B premium – the amount you pay every month for Original Medicare Part B coverage. It is usually deducted from your Social Security check.
  • Premium – a fee you pay each month for your Medicare plan. (separate from Part B)
  • Provider network – these are the doctors, hospitals, and specialists that will accept your Medicare plan. Generally, you pay less if you get care from providers in your plan’s network.

Of course, we’ve only scratched the surface on all things Medicare and Medicare education. Make sure that you check out other Aspire Health Plan blog posts in our All About Medicare category. And if you have any questions, do not hesitate to contact us at (855) 378-9680. (TTY users call 711.).

Get all the information you need. Request a free Guide to Medicare

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Aspire Health is a Medicare Advantage HMO plan sponsor with a Medicare contract. Enrollment in Aspire Health depends on contract renewal.

Medicare beneficiaries may also enroll in Aspire Health through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov. Every year, Medicare evaluates plans based on a 5-star rating system. For accommodation of persons with special needs at meetings call 1-855-570-1600 (TTY: 711) Other Providers are available in our network. Out-of-network/non-contracted providers are under no obligation to treat Aspire Health members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1- 877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

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Page last updated: December 11, 2023

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