US Senior Benefits Resource Center of Ohio

Fast fact: When they say your formulary they mean a list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits. Also called a drug list.

COBRA stand for Consolidated Omnibus Budget Reconciliation Act. It's a law that protects you and your family if you lose your employer-sponsored health benefits. If you qualify for COBRA coverage, then you have the option of continuing your employer-sponsored health plan for a limited period of time.

AEP begins October 15 and ends December 7 each year. During AEP, you can enroll in, disenroll from or change your Medicare Advantage plan or your prescription drug plan. You can also return to Original Medicare. Elections made during AEP are effective January 1 of the following year.

Non-Preferred Provider is a provider who doesn’t have a contract with your plan to provide services. If your plan covers out-of-network services, you’ll usually pay more to see an out-of-network provider than a preferred provider. Your policy will explain what those costs may be. May also be called “non-preferred” or “non-particiapting” instead of “out-of-network provider”.

Out-of-network Copayment is a fixed amount (for example, $30) you pay for covered health care services from providers who do not contract with your health insurance or plan. Out-of-network copayments usually are more than in-network copayments.

In-network Coinsurance is your share (for example, 20%) of the allowed amount for covered health care services. Your share is usually lower for in-network covered services.

Starting to get bombarded with Medicare information in your mailbox? It can be overwhelming! Contact us today to review your situation.

We believe that the better educated you are about Medicare, the easier it will be for you to make the right decisions about your Medicare health insurance choices.

Quick Tip: If you forget your Medicare card, you, your doctor or other health care provider may be able to look up your Medicare Number online.

Reminder: Only give your Medicare Number to doctors, pharmacists, other health care providers, your insurers, or people you trust to work with Medicare on your behalf.