To help you navigate these options and find the best plan for your needs, we’ve teamed up with Chapter to provide personalized, 1-1 guidance.


Navigating Medicare involves understanding key enrollment periods, plan types, and coverage details. Knowing when you can enroll, what costs to expect, and how your plan works ensures you get the healthcare you need. This guide explains essential terms related to enrollment, plan coverage, and cost management to help you make informed decisions about your Medicare plan.

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Glossary of Important Terms for Annual Enrollment

  • Enrollment Periods:
  • Annual Election Period (AEP): October 15 to December 7, when you can change your Medicare plan.
  • Initial Enrollment Period (IEP): A 7-month period when you first become eligible for Medicare.
  • Special Enrollment Period (SEP): Special times to change your plan due to life events, outside regular enrollment periods.
  • Plan Types and Coverage:
  • Dual Eligible Special Needs Plan (D-SNP): For those eligible for both Medicare and Medicaid.
  • Drug Formulary: A list of prescription drugs covered by a Medicare Part D plan.
  • Costs and Payments:
  • Premium: Monthly payment for Medicare coverage.
  • Deductible: Amount you pay before Medicare starts covering costs.
  • Co-payment: Fixed amount for each doctor visit or service.
  • Coinsurance: Percentage of costs paid after the deductible is met.
  • Out-of-Pocket Costs: Costs not covered by Medicare, including co-payments and coinsurance.
  • Coverage Gap (Donut Hole): Temporary limit on what Medicare Part D covers for prescriptions.
  • Authorizations and Approvals:
  • Prior Authorization: Approval needed from Medicare before certain services are covered.
  • Coverage Documents:
  • Annual Notice of Changes (ANOC): Annual update on changes to coverage or costs.
  • Evidence of Coverage (EOC): Document outlining Medicare plan benefits for the year.
  • Healthcare Services:
  • Benefit Period: Time frame used to measure use of hospital and skilled nursing services.
  • In-network/Out-of-network: Whether your healthcare provider is covered by your plan.
  • Cost Management:
  • Cost-sharing: Portion of healthcare costs you pay, such as co-payments and coinsurance.
  • Maximum Out-of-Pocket (MOOP): Cap on annual out-of-pocket expenses for Medicare services.

By understanding key Medicare terms such as enrollment periods, coverage options, and cost-sharing, you can navigate your healthcare more confidently. Stay informed about your plan’s annual updates and use these terms as a guide to ensure you're getting the best coverage for your needs.


To help you navigate these options and find the best plan for your needs, we’ve teamed up with Chapter to provide personalized, 1-1 guidance.