Page 11 - Cover Letter and Medicare Evaluation for Scot Paltrow
P. 11
Plans that appear to meet your criteria (cont'd)
Aetna Medicare Premier
Medigap Plan Name Medigap Plan G Medigap Plan N
Advantage Plan (PPO)
Toll-Free Number NA NA Already enrolled
Estimated annual premiums for medical coverage
lity ratings from Medicare web site (best rating = 5 stars)
2021 Standard Part B
premium ($148.50 a $1,782 $1,782 $1,782
month)*
Health plan annual
premiums (Medigap $3,400 $2,700 $532
premiums are estimates)
Total $5,182 $4,482 $2,314
Minimum costs for Medicare-covered services
Total medical premiums $5,182 $4,482 $2,314
(from above)
Plan health deductible
(includes Part B deductible if $203 $203 $0
not covered by plan**)
Annual Rx costs, mail-
order (premiums, $4,282 $4,282 $3,191
deductibles, co-pays)
Total Minimum Costs
(includes cost-sharing for the $9,667 $8,967 $5,505
Rx drugs you now take)
Cost-sharing for doctors office visits
=
In-Network Primary After the annual Part B
Care Co-Pays deductible of $203 is paid, $5
No co-pays after annual there are up to $20 co-
In-Network Specialist Part B deductible ($203) is payments for doctors'
Co-Pays paid office visits and a $50 co- $45
Out-of-Network pay for a visit to the
Co-Pays emergency room. $50 PCP; $60 specialist
*This is 2021 standard Part B premium for new enrollees who are not yet receiving Social Security benefits.
**Part B deductible in 2021 is $203.
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