Glossary & FAQ
Every Medicare term and top question in plain English — searchable. Have a specific term? Type it below. Every FAQ has its own link, so I can send you a direct URL.
Frequently asked
Do I need Part B if I'm still working past 65?▾
If your employer has 20+ employees and you have creditable coverage, you can typically delay Part B without penalty and enroll during an 8-month SEP after leaving. Smaller employers usually require Part B at 65 — check with HR.
Direct linkWhat's the penalty if I delay Medicare?▾
Part B adds 10% for each full 12 months you were eligible and not enrolled — permanently. Part D adds about 1% of the national base premium ($36.78 in 2025) for each month you went without creditable drug coverage — permanently.
Direct linkWhich is better — Medigap or Medicare Advantage?▾
Neither is 'better' universally. Medigap = higher premium, near-zero surprise bills, any Medicare doctor. Advantage = low or $0 premium, network-based, copays as you go, often bundles dental/vision. The right choice depends on your health, doctors, travel, and budget.
Direct linkCan I keep contributing to my HSA after 65?▾
Only if you delay Medicare entirely. Enrolling in any part of Medicare — including premium-free Part A — stops HSA contributions. If you take Social Security, Part A is automatic.
Direct linkCan I switch Medicare plans anytime?▾
Most changes are made during the Annual Election Period (Oct 15 – Dec 7). Certain life events open a Special Enrollment Period. Medigap changes usually require underwriting outside your initial 6-month Medigap open enrollment.
Direct linkDoes Medicare cover dental, vision, or hearing?▾
Original Medicare does not cover routine dental, vision, or hearing. Most Medicare Advantage plans include some coverage. Standalone dental/vision plans are also available.
Direct linkWhat happens to my spouse's coverage when I go on Medicare?▾
Medicare only covers you, not your spouse. If your spouse relied on your employer plan, they'll need their own coverage — usually COBRA temporarily, then ACA Marketplace until they qualify for Medicare.
Direct linkDo I need to review my Medicare plan every year?▾
Yes. Plan premiums, drug formularies, and provider networks change every January. A 15-minute review during AEP each fall usually saves money and prevents surprises.
Direct linkGlossary
- AEP (Annual Election Period)
- October 15 – December 7 each year. Anyone with Medicare can change Advantage or Part D plans; changes take effect January 1.
- COBRA
- Federal law letting you keep your employer health plan (usually up to 18 months) after leaving a job. COBRA is not creditable coverage for Medicare — you still owe a Part B penalty if you delay past your IEP.
- Creditable coverage
- Prescription coverage at least as good as standard Medicare Part D. If you keep creditable coverage, you avoid the Part D late enrollment penalty.
- Deductible
- The amount you pay out-of-pocket for covered care before the plan starts paying.
- Formulary
- A plan's list of covered prescription drugs, sorted into pricing tiers. Formularies change annually.
- GEP (General Enrollment Period)
- January 1 – March 31 for people who missed their IEP and don't qualify for a Special Enrollment Period. Coverage starts the month after enrollment.
- IEP (Initial Enrollment Period)
- Your 7-month window to enroll in Medicare: 3 months before, the month of, and 3 months after your 65th birthday.
- IRMAA
- Income-Related Monthly Adjustment Amount — a surcharge on Parts B and D for higher earners. Based on your MAGI from 2 years prior.
- LEP (Late Enrollment Penalty)
- A permanent surcharge added to Part B (10% per year late) or Part D (1% of the national base premium per month late) if you enroll after your window without creditable coverage.
- MA / Medicare Advantage (Part C)
- A private plan that bundles Parts A and B, usually includes Part D, and often adds dental, vision, and hearing. Uses a network.
- MAPD
- A Medicare Advantage plan that includes prescription drug coverage.
- Medigap (Medicare Supplement)
- A private plan that pays your share of Original Medicare costs. Plan G is the most common today. Works with any provider that accepts Medicare.
- MOOP (Maximum Out-of-Pocket)
- The most you'd pay in a year for covered in-network services on a Medicare Advantage plan. Original Medicare has no MOOP.
- Original Medicare
- Parts A (hospital) and B (medical) — the federal program itself, before adding a Medigap, Part D, or Advantage plan.
- Part A
- Hospital insurance. Most people pay $0 premium if they or a spouse worked 40+ quarters.
- Part B
- Medical insurance (doctors, outpatient, preventive). Standard 2025 premium: $185/month; higher with IRMAA.
- Part D
- Prescription drug coverage — standalone (PDP) or bundled into an Advantage plan (MAPD).
- PDP
- Prescription Drug Plan — a standalone Part D plan paired with Original Medicare.
- SEP (Special Enrollment Period)
- A window to enroll or change plans outside AEP due to a qualifying event — losing employer coverage, moving, or plan termination.
- Underwriting
- Health questions used to approve or price a Medigap plan when you're outside your Medigap open enrollment or a guaranteed-issue window.
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