Plain-English definitions of the terms that run a Medicare practice — enrollment periods, compliance, and licensing.
AHIP is America's Health Insurance Plans, a national trade association. In Medicare sales, “AHIP” usually refers to the annual AHIP Medicare training and certification that agents complete to sell Medicare Advantage and Part D plans for most carriers.
The Medicare Annual Enrollment Period (AEP) is the window each fall — October 15 to December 7 — when people with Medicare can join, switch, or drop a Medicare Advantage or Part D prescription drug plan. Changes made during AEP take effect January 1.
A Dual-Eligible Special Needs Plan (D-SNP) is a type of Medicare Advantage plan for people who qualify for both Medicare and Medicaid. D-SNPs coordinate benefits across both programs and often include extra support and supplemental benefits.
A Field Marketing Organization (FMO) is an intermediary between insurance carriers and agents. It contracts agents with carriers, supplies leads, training, and back-office support, and earns overrides on the business its downline agents produce.
An Independent Marketing Organization (IMO) is a marketing organization that contracts and supports agents selling insurance products, much like an FMO. The terms IMO and FMO are often used interchangeably.
An Individual Coverage Health Reimbursement Arrangement (ICHRA) lets an employer reimburse employees, tax-free, for individual health insurance premiums and qualified medical expenses instead of offering a traditional group health plan.
Medicare Advantage (Part C) is an alternative to Original Medicare offered by private insurers approved by Medicare. MA plans bundle Part A and Part B, usually include Part D drug coverage, and often add benefits like dental, vision, and hearing.
A MAPD is a Medicare Advantage plan that includes Part D prescription drug coverage — the most common form of Medicare Advantage. “MA-only” plans without drug coverage also exist, often paired with a standalone Part D plan.
Medigap, or Medicare Supplement insurance, is private coverage that pays some of the out-of-pocket costs Original Medicare doesn't — such as copays, coinsurance, and deductibles. Plans are standardized and labeled by letter (Plan G, Plan N, and so on).
A National Producer Number (NPN) is a unique identifier assigned by the National Association of Insurance Commissioners (NAIC) to insurance producers and agencies, used to track licensing and appointments across states.
The Medicare Advantage Open Enrollment Period (OEP) runs January 1 to March 31 each year. It lets someone already enrolled in a Medicare Advantage plan make one change — switch to a different MA plan, or return to Original Medicare and add a Part D plan.
A Prescription Drug Plan (PDP), or Medicare Part D, is private insurance that adds outpatient prescription drug coverage to Original Medicare. PDPs use formularies — lists of covered drugs organized into cost tiers.
A Scope of Appointment (SOA) is a CMS-required document that records a Medicare beneficiary's permission to discuss specific product types — such as Medicare Advantage, Part D, or Medicare Supplement — before a personal marketing appointment.
A Special Enrollment Period (SEP) is a window outside the regular Medicare enrollment periods when a person can join, switch, or drop coverage because of a qualifying life event — such as moving, losing employer coverage, or qualifying for Extra Help.
