Below you'll find definitions of general Medicare terms as well as specific terms related to Generations Advantage plans. You'll also find contact information for state and federal agencies and programs related to Medicare.
Our "Next Steps" section below guides you to more learning resources.
A Medicare Advantage plan offered under Martin's Point Generations Advantage. Learn More
A Medicare Advantage plan offered under Martin's Point Generations Advantage. Learn More
The Martin's Point Prepaid Mastercard® is sent to all Generations Advantage members. It can be used to pay directly for items covered under Generations Advantage Wellness Wallet and Eyewear benefits, up to the plan's annual allowance - eliminating the need for cash upfront or reimbursement requests. Learn More
A Medicare Advantage plan offered under Martin's Point Generations Advantage. Learn More
A Medicare Advantage plan offered under Martin's Point Generations Advantage. Learn More
A Medicare Advantage plan offered under Martin's Point Generations Advantage. Learn More
Fitness/wellness reimbursement benefit offered with all Generations Advantage plans. See each plan’s benefit details for covered services and equipment. Learn More
When you and your insurance plan share the cost of care based on a percentage. For example, a plan might pay 80% of the cost for a service and you pay the remaining 20%. Percentages vary by plan and service.
When you and your insurance plan share costs based on a flat dollar amount that you pay. For example, at an office visit or a pharmacy, you may be asked to pay a $10 or $20 “copay” or other flat fee.
The amount you must pay each year for health care or prescriptions before your insurance begins to share costs with you.
Under Part D, your coverage is divided into three cost-sharing phases: Deductible Phase, Initial Coverage Phase, and the Catastrophic Coverage Phase. Learn more about Drug Coverage Phases
A list of prescription drugs covered by a health insurance plan.
A drug source is simply where you fill your prescriptions. Your drug costs will vary depending on whether you fill your prescriptions at a network pharmacy with standard or preferred cost sharing or through the CVS Caremark mail order service.
Part D prescription drugs are divided into pricing tiers. Depending on the tier and coverage phase, your drug costs will be a fixed amount (copay) or a percentage of the total cost (coinsurance). View your plan's Drug Tiers
A type of Medicare Advantage plan that generally requires the use of in-network providers except for urgent/emergency care.
A type of Medicare Advantage plan with lower costs for in-network services and the option to use out-of-network providers for some services at a higher cost.
A type of Medicare Advantage plan with a network of preferred providers and the option to see out-of-network providers, usually at a higher member cost.
The total amount that you will have to pay “outof-pocket” each year for hospital and medical copays and coinsurances for covered services before your insurance will start paying 100% of these costs for covered services.
NOTE: Monthly premiums and prescription drug costs are not included when figuring out-of-pocket costs.
Medigap, also known as Medicare supplement insurance, is a supplemental health insurance policy sold by private companies to help cover out-of-pocket costs incurred under Original Medicare. It's designed to fill the "gaps" in Original Medicare coverage, which doesn't have a limit on out-of-pocket expenses. Essentially, it provides additional coverage for costs like deductibles, co-payments, and co-insurance related to services covered by Original Medicare.
Medicare Advantage, also known as Medicare Part C, is a program that allows individuals to receive Medicare benefits through private health plans. These plans, approved by Medicare, cover the same services as Original Medicare (Parts A and B) and may also include additional benefits like prescription drug coverage (Part D), dental, vision, and hearing care.
Medicare Part A, also known as Hospital Insurance, helps cover inpatient care in hospitals, skilled nursing facilities, hospice care, and some home health care.
Medicare Part B, also known as medical insurance, is a voluntary part of Medicare that helps cover medically necessary services from doctors and other health care providers, outpatient care, home health care, and some durable medical equipment. It also covers certain preventive services.
Medicare Part C, also known as Medicare Advantage, is an alternative to Original Medicare (Parts A and B) that provides coverage through private companies. These plans must offer at least the same coverage as Original Medicare, but they may also include additional benefits and may have different rules and costs.
Medicare Part D is the part of Medicare that provides prescription drug coverage for those with Medicare. It's an optional, supplemental coverage offered by private insurance companies approved by Medicare. Part D plans are designed to help reduce the cost of prescription medications.
A set of health care providers who are contracted to provide health care services to patients with a particular health insurance plan. Providers can be in- or out-of-network. Search out Network of 15,000 Providers
A government-funded health insurance program for individuals 65 and older (and some younger individuals with disabilities).
The amount you pay to the government or to an insurance company each month/quarter in order to have health or prescription drug coverage.
1-800-MEDICARE (1-800-633-4227)
TTY/TDD: 1-877-486-2048
Maine Resources |
1-800-262-2232
TTY/TDD: 1-800-606-0215
207-287-2674
TTY/TDD: 711
1-866-796-2463
TTY/TDD: 1-800-423-4331
New Hampshire Resources |
1-800-852-3345 ext. 4344 or
603-271-4344
We offer a variety of Medicare Advantage plans designed to fit your health care needs and budget.
Is your doctor in our network? We have over 15,000 providers who participate in the Generations Advantage network.
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