Medicare Glossary

Coinsurance

The percentage of costs you pay for a covered health care service after you have paid your deductible. For example, under Original Medicare Part B, you pay 20% of the Medicare-approved amount for most doctor services.

Cost-sharing

The share of costs covered by your insurance that you pay out of your own pocket. This term generally includes deductibles, coinsurance, and copays — but not premiums.

Deductible

The amount you must pay out of pocket for covered health care services before your insurance begins to pay. Medicare Part A and Part B each have separate deductibles. Many Medicare Advantage plans have their own deductibles.

Extra Help

A federal program that helps people with limited income and resources pay Part D prescription drug costs, including premiums, deductibles, and copays. Also called the Low Income Subsidy (LIS).

Also known as: Low Income Subsidy, LIS

Low Income Subsidy (LIS)

See Extra Help. A federal program that reduces Part D costs for people with limited income and resources, covering most premiums, deductibles, and copays.

Also known as: LIS, Extra Help

Medicare Savings Program

State programs that help people with limited income pay Medicare premiums, deductibles, copays, and coinsurance. The four types are QMB, SLMB, QI, and QDWI, each with different income and eligibility thresholds.

Also known as: MSP

Qualified Medicare Beneficiary (QMB)

A Medicare Savings Program for people with the lowest incomes. If you qualify as a QMB, your state pays your Part A and Part B premiums, and providers who accept Medicare cannot charge you copays, coinsurance, or deductibles.

Also known as: QMB