| Tue, Oct 02, 2012 @ 09:00 AM

Decoding Medicare’s Alphabet Soup

Posted by Medicare Made Clear

open enrollment oep medicare a b c dWelcome to Countdown to OEP! This is the first part of a two-part series of posts designed to help you navigate the 2013 Medicare Open Enrollment Period (OEP). Countdown to OEP articles give you key information that can help you get ready for OEP.

In case you missed it, here’s the last Countdown to OEP blog post: 

The second part of our series, OEP Boot Camp, will start in October. We’ll take you through specific steps to review your Medicare coverage. Then you can look at  your 2013 plan choices, and take action before the OEP ends on December 7.

Part A, Part B, OEP, SNP—learning about Medicare can sometimes feel more like looking at a bowl of alphabet soup. But it’s important to understand the letters and acronyms that make up Medicare. To help you or your loved one understand the language of Medicare, check the information below.

The ABC and Ds of Medicare

Let’s start with the basics: our ABC and Ds. Medicare has four different “parts.” Each part is labeled using a letter of the alphabet.

  • Part A – Hospital insurance.

  • Part B – Doctor and outpatient insurance. Together, Part A and Part B make up Original Medicare.

  • Part C – Medicare Advantage plans. Offered by private insurance companies, these plans give you the benefits of Original Medicare and may offer extras, like dental coverage or wellness services.

  • Part D – Medicare prescription drug coverage. You can get this in a standalone plan or included in a Medicare Advantage plan.

For more detailed information about the parts of Medicare, visit Medicare Made Clear.

KYA: Know Your Acronyms

The most important acronyms to consider when you’re preparing to enroll in a Medicare plan fall into two main categories: enrollment period acronyms and plan type acronyms.

Enrollment Period Acronyms 

IEP – Initial Enrollment Period. Your IEP might fall during the Medicare OEP (see below). If you’re “aging into” Medicare, your IEP will center on your 65th birthday. If you qualify for Medicare because of a disability or other special circumstance, your IEP might depend on a different date, like the date you started receiving disability benefits.

OEP – Open Enrollment Period. The Medicare OEP happens each year from October 15 – December 7. At this time, Medicare beneficiaries can generally add, switch or drop their coverage. You might also see the acronym AEP (Annual Enrollment Period). This is just another way of saying OEP.

SEP – Special Enrollment Period. This is an enrollment period outside of “regular” enrollment periods like the IEP or OEP. You must meet certain requirements to qualify for a SEP.

Plan Type Acronyms 

MA – Medicare Advantage plan

MAPD – Medicare Advantage plan with Prescription Drug coverage

Also called Medicare Part C, these are Medicare plans offered by private insurance companies. They give you all the coverage of Original Medicare, and may offer extra benefits, too. The main types are:

  • Coordinated care plans:

    • HMO – Health Maintenance Organization. With an HMO, you usually have to use doctors and hospitals within the plan’s network to make sure the plan covers your care.

    • POS – Point Of Service. This is a type of HMO plan that lets members go outside the network for some covered services. You might have to pay a higher copayment or coinsurance for those services.

    • PPO – Preferred Provider Organization. With this type of plan, you can use doctors and hospitals inside or outside of the network. If you go outside the network, you may pay a larger share of the cost of your care.

    • SNP – Special Needs Plans. A type of Medicare Advantage plan that serves people with special health care needs, like ESRD (End Stage Renal Disease) or diabetes.

  • Other plans:

    • PFFS – Private Fee-For-Service. Allows you to visit any Medicare-eligible doctor, hospital or health care provider who accepts the plan’s payment terms and conditions.

    • MSA – Medical Savings Account. Combines a special medical savings account with a high-deductible Medicare Advantage plan.

PDP – Prescription Drug Plan. Also called Medicare Part D, this is a standalone plan that helps you pay for prescription drugs.

For more information, feel free to visit Medicare Made Clear. You can find information about the types of Medicare coverage, worksheets to help you prepare for enrollment and other helpful tools to help you decode the language of Medicare.

But wait—there’s more! Come back for the next installment of the Countdown to OEP, when it will be your Graduation to OEP Bootcamp.

For more information, contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048. If you have questions about Medicare Made Clear, call 1-877-619-5582, TTY 711, 8 a.m. – 8 p.m. local time, seven days a week.

Resources:

Learn About Medicare—MedicareMadeClear.com

Medicare Glossary—MedicareMadeClear.com

Medicare Glossary—Medicare.gov

 

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