Medicare and health insurance, explained
Short guides to the decisions that actually cost people money: when to sign up, which kind of plan to pick, and how to read what you’re paying. Figures are pulled from Medicare.gov, CMS and HealthCare.gov and dated so you know how fresh they are.
Medicare basics: Parts A, B, C and D in plain English
What each part covers, what it costs in 2026, and the sign-up deadline that trips people up.
Which Medicare enrollment period are you in?
Initial, Open, Advantage Open and Special Enrollment Periods, and what each one lets you do.
Medicare Advantage vs. Medigap: the real trade-off
Lower premiums and a network, or higher premiums and freedom. Timing decides more than people think.
What Part D drug coverage will cost you in 2027
The out-of-pocket cap rises to $2,400. What counts toward it, and how to compare drug plans.
ACA Marketplace plans: how to shop for 2027 coverage
Open Enrollment dates, metal tiers, tax credits, and when you can enroll outside the window.
Insurance terms glossary
The words on your plan documents, defined in one or two sentences each.
Glossary
If a term on your plan paperwork isn’t here, ask us and we’ll add it.
- Annual Notice of Change (ANOC)
- A letter your Medicare plan sends each fall listing changes to costs, benefits and networks for next year. Read it before October 15.
- Coinsurance
- Your share of a covered cost as a percentage. Under Part B you usually pay 20% after the deductible.
- Copay
- A flat amount you pay for a service, like $20 for a primary care visit.
- Deductible
- What you pay for covered care before your plan starts paying its share.
- Extra Help
- A federal program that lowers Part D premiums and drug costs for people with limited income and resources.
- Formulary
- The list of drugs a plan covers, sorted into tiers that set what you pay.
- HMO / PPO
- Network types. HMOs usually require in-network care and referrals. PPOs let you go out of network at a higher cost.
- IRMAA
- An income-related surcharge added to Part B and Part D premiums for higher earners, based on your tax return from two years earlier.
- Maximum out-of-pocket (MOOP)
- The yearly cap on in-network costs in a Medicare Advantage plan. Original Medicare alone has no cap.
- Medigap
- Medicare Supplement Insurance. Private policies that help pay the gaps in Original Medicare, like the 20% coinsurance.
- Premium tax credit
- A subsidy that lowers the monthly cost of an ACA Marketplace plan based on household income.
- SHIP
- State Health Insurance Assistance Program. Free, unbiased Medicare counseling in every state.
- Special Enrollment Period (SEP)
- A window outside the normal dates to change coverage, triggered by events like moving or losing other coverage.
- TPMO
- Third-Party Marketing Organization. A company like ours that markets Medicare plans on behalf of agents or carriers, and must disclose that it does not offer every plan.