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Medicare Terms in Plain English

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Common questions

What does “guaranteed issue” mean in Medicare?

It's a time or situation when an insurer must sell you a Medigap policy at the best available rate, without asking health questions or turning you down. The most common one is the six-month window when you first enroll in Part B at 65 or older.

What is prior authorization?

It's a requirement, common in Medicare Advantage plans, to get the plan's approval before it will cover certain services or medications. Original Medicare uses it far less often.

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