Medicare Glossary

Preferred Provider Organization (PPO)

A type of Medicare Advantage plan that allows you to see any provider who accepts Medicare, but you pay less when you use the plan's preferred (in-network) providers. Unlike HMOs, PPOs generally do not require referrals for specialists.

Also known as: PPO

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.

Prescription Drug Plan (PDP)

A stand-alone Medicare Part D plan that provides prescription drug coverage for people enrolled in Original Medicare. PDPs are separate from Medicare Advantage plans that already include drug coverage.

Also known as: PDP, Stand-alone Part D Plan

Primary Care Provider (PCP)

The main doctor who manages your overall health care and refers you to specialists when needed. Some Medicare Advantage HMO plans require you to choose a PCP and get referrals from them before seeing a specialist.

Also known as: PCP, Primary care doctor

Prior Authorization

Approval that your Medicare Advantage or Part D plan may require before you receive certain services or medications. Without prior authorization, the plan may not cover the cost. Original Medicare rarely requires prior authorization.

Also known as: Preauthorization, Pre-approval