Plain-English definitions of the Medicare, ACA health, and life insurance terms most consumers ask about. Each definition is reviewed by a licensed insurance professional. Cross-linked from across our editorial content so you can read in context.
Healthcare.gov and state exchanges where you buy ACA-compliant individual health insurance.
Algorithmic life insurance underwriting with no medical exam — same rate classes as fully-underwritten.
Missouri's annual guaranteed-issue Medigap switching window tied to policy anniversary.
October 15 – December 7 each year — change Medicare Advantage and Part D plans for next year.
Annual guaranteed-issue Medigap switching window in 10 states — change to equal-or-lesser plan without underwriting.
Savings component of permanent life insurance that grows tax-deferred.
Federal-state program for children whose families exceed Medicaid income limits but can't afford private coverage.
Federal law allowing 18-36 month continuation of employer health coverage after a qualifying event — at full cost.
Term life feature letting you convert to permanent insurance without new medical underwriting.
Fixed dollar amount you pay for a covered service ($25 for office visit, $10 for generic Rx, etc.).
Silver-plan-only ACA subsidy that lowers deductibles, copays, and out-of-pocket max for households under 250% FPL.
Drug coverage that's at least as good as standard Part D — keeps you penalty-free if you delay Part D.
Term life with face amount that drops over time — generally inferior to level term.
Formula for calculating life insurance need: Debt + Income (10x) + Mortgage + Education.
Annual return of premium from a mutual life insurer — based on actual mortality, expense, and investment experience.
10 categories of services every ACA-compliant plan must cover.
Federal program that pays Part D premiums and copays for low-income beneficiaries.
Annual income benchmark used to determine eligibility for ACA subsidies, Medicaid, and other programs.
Small whole life policy ($5K-$50K) sized to cover funeral and burial costs.
Federal protection requiring carriers to sell you a Medigap plan regardless of health.
Life insurance with no health questions — small face amounts, graded death benefit, highest cost per dollar of coverage.
ACA-compliant plan that meets IRS deductible/OOP-max thresholds and qualifies for HSA contributions.
Plan G coverage after a federal annual deductible (~$2,870 in 2026); cheapest Medigap monthly premium.
Health plan with closed network and primary care gatekeeper for specialist referrals.
Triple-tax-advantaged savings account paired with HDHP — for medical expenses now or later.
Employer reimburses employees tax-free for individual ACA marketplace coverage instead of offering a group plan.
Permanent life insurance with cash value tied to a stock index, with caps and floors — often oversold.
7-month window around your 65th birthday to enroll in Medicare without penalty.
Income-Related Monthly Adjustment Amount — surcharge on Part B and Part D premiums for higher-income enrollees.
Social Security form to request a reduction of IRMAA after a life-changing event.
Federal-state low-income health coverage — income limits for adults vary by state expansion status.
Carrier review of your health to decide whether to issue Medigap and at what rate — applies outside guaranteed-issue periods.
Part C — private HMO/PPO plans that replace Original Medicare, often with $0 premium.
Jan 1 – Mar 31 — current MA enrollees can change MA plans or drop MA back to Original Medicare.
State Medicaid program that pays Part B premiums for low-income Medicare enrollees.
Private insurance that pays the deductibles, copays, and coinsurance Original Medicare leaves you with.
One-time 6-month window when you can buy any Medigap plan with no medical underwriting.
Income measure used for ACA subsidies, Medicaid eligibility, and Medicare IRMAA.
Annual cap on what you pay for Medicare-covered services in a Medicare Advantage plan ($9,350 in-network for 2026).
Decreasing term life sold by mortgage lenders — usually overpriced vs. equivalent level term.
Annual window to enroll in or change ACA marketplace plans — Nov 1 to Jan 15 federally.
Whole life rider that uses dividends to buy small bits of additional fully paid-up insurance.
Hospital insurance — premium-free for most after 10 years of Medicare-taxed work.
Medical insurance for outpatient/doctor services — standard premium $185/mo in 2026.
Up to 15% above Medicare-approved amounts — only allowed in some states; covered by Plan G but not Plan N.
Standalone prescription drug coverage; required to avoid permanent late enrollment penalty.
Most comprehensive Medigap plan, but closed to those new to Medicare after 2020-01-01.
The most comprehensive Medigap plan available to those new to Medicare today.
Health plan with broader network and out-of-network coverage at higher cost-sharing.
Federal subsidy that lowers your monthly ACA marketplace premium based on income.
Above-the-line deduction for self-employed health insurance premiums — Form 1040 Schedule 1.
Non-ACA-compliant temporary health coverage — useful as a stopgap, problematic as a permanent solution.
Life insurance with no medical exam but extensive health questions — quick issue, smaller face amounts.
Medicare Advantage plans tailored to chronic conditions, dual eligibility, or institutional residence.
60-day window to enroll in or change ACA marketplace coverage outside Open Enrollment, triggered by a Qualifying Life Event.
Pure death benefit life insurance for a set period (10/20/30 years), no cash value.
12-month guaranteed-issue Medigap window if you joined Medicare Advantage at first eligibility.
Permanent life insurance with lifetime coverage and slow-growing cash value.