Important Terms

At Gallardo Insurance Services, our experienced team, led by Lizeth Ocana, helps you understand important Medicare terms. During the Annual Enrollment Period (AEP), you can choose or change your Medicare Advantage plan for the following year. We explain coinsurance, copayment, deductible, formulary, HMO, IEP, Original Medicare, PPO, premium, and Special Needs Plans, ensuring you have clarity about these key concepts. Trust us to guide you through the complexities of Medicare and find the right coverage for your specific needs.

Annual Enrollment Period (AEP):

From Oct. 15 – Dec. 7 people who are Medicare eligible can enroll in or disenroll from or change to the Medicare Advantage plan of their choice for the following year.


A percentage of your medical and drug costs that you pay out of pocket.


Also called a drug list, the formulary lists the drugs your plan covers. It’s often divided into sections or tiers, based on the copayment for the covered drugs.

Initial Enrollment period (IEP):

This is your first chance to sign up for Medicare. It starts 3 months before your 65th birthday, includes the month you turn 65, and ends 3 months after the month you turn 65.

Preferred Provider Organization:

This type of health plan gives you the freedom to choose your own doctors and hospitals.

Special Needs Plans:

Plans that may offer benefits, providers, and drug lists are designed to meet the specific needs of the groups they serve. People with chronic conditions, like diabetes or heart conditions, or who are dually eligible for Medicare and Medicaid may benefit from this type of plan.


The fixed dollar amount you pay when you receive medical services or have a prescription filled.


The amount you pay for medical services or prescriptions before your plan pays for benefits.

Health Maintenance Organization (HMO):

Generally, a primary care physician arranges your healthcare in the plan’s network.

Original Medicare:

The traditional fee-for-service program is offered directly by the federal government which pays for your healthcare. You can see any doctor who takes Medicare anywhere in the country.


What you pay Medicare or a Medicare Plan for healthcare coverage.

Lizeth Gallardo, at Gallardo Premium Insurance Services, specializes in Medicare and is fluent in all its intricacies. Trust her expertise to guide you through the complexities of Medicare and help you find the coverage that best suits your needs.

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