Medicare Glossary

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.

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

Grace Period

A set amount of time after a premium due date, typically extending into the following month or two, during which you can still pay a missed Medicare Advantage, Part D, or Medigap premium before losing coverage.

IRMAA (Income-Related Monthly Adjustment Amount)

An extra amount added to your Part B and Part D premiums if your income is above a certain threshold, based on the tax return from two years earlier. IRMAA is reassessed annually and can be appealed after certain life-changing events like retirement.

Also known as: IRMAA

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

Premium

The amount you pay for your Medicare coverage, typically deducted monthly. Part A is premium-free for most people. Part B has a standard monthly premium (adjusted for income). Medicare Advantage and Part D plans have their own premiums in addition to Part B.

Qualified Disabled and Working Individual (QDWI)

A Medicare Savings Program that helps pay Part A premiums for certain people under 65 with disabilities who returned to work and lost premium-free Part A.

Also known as: QDWI

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

Qualifying Individual (QI)

A Medicare Savings Program that helps pay Part B premiums for people with slightly higher income than SLMB allows. Funding is limited each year and applications are approved on a first-come, first-served basis.

Also known as: QI Program

Specified Low-Income Medicare Beneficiary (SLMB)

A Medicare Savings Program that helps pay Part B premiums for people with income modestly above the Qualified Medicare Beneficiary (QMB) limit.

Also known as: SLMB