Prescription and Medical Terms
The percentage of the cost you pay for a service
Coinsurance
Approval from your primary doctor to see a specialist
Referral
A set dollar amount you pay when you get care
Copay
The main doctor who manages your care and referrals
Primary Care Provider (PCP)
The amount you pay out of pocket before your plan starts helping with certain services
Deductible
A specific time of year when you’re allowed to join, change, or leave a Medicare plan
Enrollment Period
The most you’ll pay for covered medical services in a year
Maximum Out-of-Pocket
Two plan types one usually costs less but requires staying in network and the other offers more flexibility
HMO vs PPO
A way your plan groups medications by cost
Tier
These plans are designed for people who qualify for both Medicare and Medicaid
D-SNP Eligibility