Confused about insurance terms? Here’s a guide

With so many abbreviations, acronyms and confusing sub-categories, the terms surrounding health coverage can become overwhelming. Here, a list of the most common letters and terms found in the Medicare alphabet.

PART A

Inpatient hospital insurance. It pays 80% of the bills and is partof original Medicare.

PART B

This covers doctor visits and other medical services and supplies. It has a monthly premium and a yearly deductible.

PART C

These are optional Medicare Advantage plans (Supplemental Medicare). Drugs are included, as well as other benefits, with no monthly premiums, but provider choice can be limited. (SeeHMO)

PART D

These policies are optional prescription drug plans for people enrolled in Original Medicare. There are monthly premiums and drug co-pays.

EPO (Exclusive Provider Organization)

Insurance will pay for doctor services within a network, but not for non-emergency treatments out of the network.

HDHP

A high-deductible health plan. You pay a large deductible before insurance starts to pay. This usually offers the lowest monthly premiums.

HMO (Health Maintenance Organization)

With an HMO, insurance coverage is usually limited to a specific group of healthcare providers. Seeing a specialist requires a referral. Medicare Advantage plans are generally HMOs.

MEDIGAP

Offers additional coverage of some or all of Medicare copays and other services. There are eight 2020 plans for Medicare newcomers, labeled A, B, D, G, K, L, Mand N. varying in monthly premium costs and deductibles.

PPO (Preferred Provider Organization)

Offers a wide of health providers with a preference for networks with negotiated service and cost contracts. Most but not all Medigap plans are PPOs.

POS (Point of Service)

This is a hybrid of an HMO and PPO, with lower out-of-pocket costs for in-network providers. It requires that you have a primary physician for all referrals.

– CATHERINE GAUGH

Custom Publishing Writer