What do all of those words mean?

Deductible Limits– The amount of money that must be paid before the insurance company will pay a covered claim.

Coinsurance– After the deductible is met, the insured will pay a percentage of the payment made against a claim. For example, 80/20 coinsurance on a $1000 bill would obligate the insured to pay $200, and the insurance company would pay $800.

CoPayment– Often called a copay, a copayment is a flat amount paid for a covered service.

Out-of-Pocket-Maximum– The most an insured will typically pay for covered services in the plan term. The maximum-out-of-pocket limit can usually be calculated by adding the deductible and coinsurance limits.

Effective Date– The date in which coverage goes into effect.

Medicare Part A– Helps with hospital costs.

Medicare Part B– Helps with doctor visits and outpatient care.

Medicare Part D– Helps pay for prescription drugs.

Medicare Supplement Insurance Plan (Medigap)– Helps cover costs not picked up by Medicare Part A or Part B.

Medicare Advantage (Part C)– A plan that is operated by a private insurance company that replaces Medicare Part A, Part B, Part D, and Medigap. This plan combines hospital costs, doctor visits, and outpatient care into one plan.

Preferred Provider Organization (PPO)– This type of plan usually has the least restrictive network. Generally, out of network services are covered, though the cost might not be as favorable. For example, if an in-network deductible is $1000, an out-of-network deductible might be $3000.

Exclusive Provider Organization (EPO)– This type of plan is considered a hybrid between a PPO and HMO. EPO plans usually do not require a coordination through a primary care physician (gatekeeper). Generally, out-of-network services are not covered, except for emergencies.

Health Maintenance Organization (HMO)– This type of plan usually has the most restrictive network of providers. Care must be coordinated through a primary care physician (gatekeeper). Generally, out-of-network services are not covered.

Obviously, there might be different coverages needed for each person. Medicare needs are unique to each individual person. However, Kraft Insurance Services can help you determine what Medicare option is best for you.