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Medicare Open Enrollment Terminology You Need to Know

By: Inter Valley Health Plan





Time is flying by and Medicare Open Enrollment is only one month away. Hopefully at this point, you are already well on your way to gathering the necessary information you need to make the best healthcare decisions possible for this next year. 

As we know, the Open Enrollment process can be confusing and the certain acronyms and other terminology can be misleading or hard to understand. To help you navigate the Open Enrollment waters a bit more easily, we have explained some of the most commonly used terms and acronyms that you’ll want to know.

        • Formulary: This is a list of medications covered by a particular plan, otherwise known as a “drug list.”

        • Network: This refers to the group of health care providers, such as hospitals, doctors and pharmacies, that agrees to provide care to the members of a Medicare Advantage coordinated care plan. These providers are called “network providers” and “network pharmacies.”

        • Extras: In a health plan, this can refer to extra coverage, like vision, hearing, dental, and/or health and wellness programs.


What about Medicare Parts A-D? Let’s briefly explain the differences here as well:

        1. Medicare Part A: This includes hospitalization, skilled nursing facilities, home health care and hospice care.

        2. Medicare Part B: The part of Medicare insurance that covers services and supplies that are medically necessary to treat your health condition. This can include outpatient care, preventive services, ambulance services, and durable medical equipment.

        3. Medicare Part C: This is also known as Medicare Advantage. These plans are administered by private insurance companies to provide coverage from Parts A and B. They also typically include prescription drug coverage as well.

        4. Medicare Part D: This is also known as the Prescription Drug Plans (PDP) that cover medications and drug coverage.

As you navigate and prepare for Open Enrollment, don’t hesitate to seek guidance from Medicare Specialists. For a full list of Medicare classes with on-site Medicare Specialists in your area, please visit ivhp.com/enrollment-events.


Article From Inter Valley Health Plan

 





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