Open enrollment period
A period when new beneficiaries may elect to enroll in a policy of insurance regardless of health. For Medicare beneficiaries an annual period during which Medicare beneficiaries can switch Medicare Advantage plans or leave Medicare Advantage altogether and go back to original Medicare. The OEP occurs January 1 through March 31 each year. Medicare Advantage plans are not required to open their plans for enrollment during an OEP.
Open panel
A type of health plan other than a closed panel plan that provides incentives for the enrollee to use providers selected by the plan.
Optional supplemental benefits
Additional benefits offered by Medicare coordinated care plans that you may choose and that may include additional premiums.
Ordinary life insurance
(See Whole life insurance)
Organization determination
A decision by a Medicare Advantage organization regarding the amount of service provided or the price the plan will reimburse for the service.
Original equipment manufacturer (OEM) parts
Refers to the use of replacement parts which are made by the same manufacturer which produced the original parts.
Original Medicare
(See Medicare)
Out-of-pocket costs
Expenses paid by you in addition to plan premiums, which may include any or all of the following:
  • Deductible: A fixed amount paid for covered services prior to the plan making payments. Deductibles are usually required to be paid annually. Expenses counted towards your Medicare deductible are the amounts that Medicare would pay for the service, not what you may have actually paid.
  • Copayment: A fixed dollar amount. For example, many health plans require that you pay a fixed amount for each drug prescription you receive.
  • Coinsurance: A fixed percentage of the total cost of services, paid each time you use the service.
Outline of coverage
The document given to each individual policyholder or group health plan member that summarizes the benefits, copayment, coinsurance, deductibles and other requirements for obtaining services covered by the individual policy or group health plan that are listed in full detail in the contract.

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