AEC Insure Medicare Glossary

Welcome to the AEC Insure Learning Glossary — your plain-language guide to Medicare and health insurance.
We’ve broken down the confusing industry jargon into simple explanations, so you can make confident decisions about your coverage. Whether you’re turning 65, comparing Medicare plans, or just trying to understand your options — this is your one-stop resource for clarity.

A

Annual Enrollment Period (AEP):
The time each year (October 15 – December 7) when you can join, switch, or drop a Medicare plan.

Assignment:
When a doctor or provider agrees to accept Medicare’s approved amount as full payment for covered services.

B

Benefit Period:
The length of time Medicare covers you for inpatient hospital or skilled nursing care. It begins the day you’re admitted and ends after you’ve gone 60 days without inpatient care.

Broker:
A licensed insurance professional — like AEC Insure — who helps you compare Medicare plans and enroll in the one that fits your needs.

C

Coinsurance:
Your share of the costs after you’ve met your deductible. Usually shown as a percentage (for example, 20%).

Copayment (Copay):
A fixed dollar amount you pay for a specific service or prescription.

Coverage Gap (“Donut Hole”):
A temporary limit in Medicare Part D prescription coverage after you and your plan have spent a certain amount on medications.

D

Deductible:
The amount you pay for covered health services before your insurance or Medicare starts to pay.

Dual Eligible:
Someone who qualifies for both Medicare and Medicaid benefits.

E

Enrollment Period:
Specific times during the year when you can sign up for or change your Medicare coverage.

Extra Help:
A federal program that helps lower-income individuals pay for Medicare prescription drug costs.

F

Formulary:
The list of prescription drugs covered by a Medicare Part D plan.

M

Medicare Advantage (Part C):
All-in-one alternative to Original Medicare offered by private insurance companies. Often includes prescription drug, dental, vision, and hearing coverage.

Medigap (Medicare Supplement):
Optional plans that help pay the out-of-pocket costs not covered by Original Medicare (like deductibles and copays).

O

Out-of-Pocket Maximum:
The most you’ll pay for covered services in a year before your plan covers 100% of the costs.

Original Medicare:
The traditional federal Medicare program — includes Part A (hospital) and Part B (medical).

P

Part A:
Covers hospital stays, skilled nursing, hospice, and some home health care.

Part B:
Covers doctor visits, outpatient care, preventive services, and durable medical equipment.

Part D:
Prescription drug coverage through private Medicare-approved plans.

Premium:
The amount you pay each month for your Medicare or insurance coverage.

Primary Care Provider (PCP):
Your main doctor who coordinates your care and referrals to specialists.

S

Special Enrollment Period (SEP):
A time outside regular enrollment periods when you can sign up for Medicare due to specific life events (like losing employer coverage or moving).

T

Turning 65:
When you first become eligible for Medicare. AEC Insure helps you navigate your Initial Enrollment Period and choose the right coverage mix.

Need Help Decoding Your Medicare Options?

AEC Insure makes Medicare simple, digital, and personal.
👉 Book your free consultation online and let us help you find coverage that protects your health — and your wallet.