Insurance Glossary
Insurance can be confusing. We've broken down the most common terms to help you understand your coverage options better.
Annual Enrollment Period (AEP)
Medicare- The time of year (Oct 15 - Dec 7) when you can change your Medicare Advantage or Part D coverage.
Beneficiary
Life Insurance- The person or entity designated to receive the death benefit from a life insurance policy.
Coinsurance
General- Your share of the costs of a covered health care service, calculated as a percent (for example, 20%) of the allowed amount for the service.
Copayment (Copay)
General- A fixed amount you pay for a covered health care service, usually when you receive the service.
Death Benefit
Life Insurance- The payout to the beneficiary of a life insurance policy, annuity, or pension when the insured dies.
Deductible
General- The amount you pay for covered health care services before your insurance plan starts to pay.
Initial Enrollment Period (IEP)
Medicare- The 7-month period when someone is first eligible for Medicare, beginning 3 months before they turn 65.
Medicare Advantage (Part C)
Medicare- An "all in one" alternative to Original Medicare, offered by private companies approved by Medicare.
Medicare Part A
Medicare- Hospital insurance that covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
Medicare Part B
Medicare- Medical insurance that covers certain doctors' services, outpatient care, medical supplies, and preventive services.
Medicare Part D
Medicare- Prescription drug coverage that helps pay for both brand-name and generic drugs.
Medigap (Medicare Supplement)
Medicare- Extra insurance you can buy from a private company to help pay your share of out-of-pocket costs in Original Medicare.
Network
General- The facilities, providers and suppliers your health insurer or plan has contracted with to provide health care services.
Open Enrollment Period (OEP)
ACA- The yearly period (Nov 1 - Jan 15 in most states) when people can enroll in an ACA health insurance plan.
Out-of-pocket Maximum
General- The most you have to pay for covered services in a plan year. After you spend this amount on deductibles, copayments, and coinsurance, your health plan pays 100% of the costs of covered benefits.
Premium Tax Credit
ACA- A refundable credit that helps eligible individuals and families cover the premiums for their health insurance purchased through the Health Insurance Marketplace.
Rider
Life Insurance- An add-on provision to a basic insurance policy that provides additional benefits to the policyholder at an additional cost.
Special Enrollment Period (SEP)
General- A time outside the yearly Open Enrollment Period when you can sign up for health insurance. You qualify for an SEP if you've had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child.
Term Life Insurance
Life Insurance- A type of life insurance that guarantees payment of a stated death benefit if the covered person dies during a specified term.
Underwriting
General- The process that an insurance company uses to evaluate the risk of insuring a person.