The most you pay in a year for covered Part A and Part B services from in-network providers in a Medicare Advantage plan. Drug costs do not count toward it.
Copay
A set dollar amount you pay for a covered service, such as $20 for a doctor visit.
Coinsurance
A percentage of the cost you pay for a covered service, such as 20%.
D-SNP
A Special Needs Plan for people who have both Medicare and Medicaid.
C-SNP
A Special Needs Plan for people with certain chronic or disabling conditions.
I-SNP
A Special Needs Plan for people who live in a nursing home or other facility, or need that level of care at home.
Part B giveback
Some Medicare Advantage plans pay part of your Part B premium. The amount is listed in CMS files as a Part B premium reduction.
Star rating
Medicare evaluates plans every year based on a 5-star rating system. 5 stars is the highest. Medicare Advantage plans with drug coverage show an overall rating, Medicare Advantage plans without drug coverage show a Part C rating, and drug plans show a Part D rating. When CMS has no rating it shows "Plan too new to be measured" or "Not enough data available."
Low performing plan icon
The Low Performing Icon means that this plan's contract received a summary rating of 2.5 stars or below in Part C or Part D or both for the last 3 years. Medicare may not allow online enrollment in this plan on Medicare.gov. To enroll, contact the plan or call 1-800-MEDICARE (TTY 1-877-486-2048).
Summary of Benefits
A document from the plan company that lists the plan's costs and benefits for the year.