Page 2 - Cover Letter and Evaluation for Janet Tuma

then, there are relatively few co-payments after the Part B deductible ($203) has been satisfied.
Another difference is that unlike Advantage plans, Medigap policies do not have networks.
Therefore, people who have Medigap policies are covered when they see any medical provider
who accepts Medicare.

In Illinois, the only time you will be able to get a Medigap policy without having to answer
questions about your health is the six-month period that starts when you get Part B (August 1,
in your case). After this initial six-month period is past, you will have to disclose any pre-existing
conditions and could be charged higher premiums or in some cases denied coverage.

Even when people know that they are going to enroll in an Advantage plan, it’s good to be
aware of this six-month guaranteed issue period for Medigap policies. Still, some people who
are in relatively good health will wait until later in retirement to get their first Medigap policy,
although it will likely be more expensive than if they had purchased it at age 65.

The basics of Advantage plans

Medicare Advantage plans are managed care plans – HMO’s and PPO’s, for the most part. In
contrast to Medigap policies, Advantage plans usually have low premiums. The three
Advantage plans in your evaluation, for instance, all have zero premiums and no deductibles for
their medical/health coverage as well as for their prescription drug coverage. And many
Advantage plans, including the three in your evaluation, offer “extra benefits” that Medicare
does not cover. Examples are dental and routine vision coverage, discussed below.

One potential downside of Advantage plans is that if you have high medical costs, you could
wind up paying more than you would in a Medigap policy. The reason is that the Advantage
plan has larger coverage gaps than does a comprehensive Medigap plan.

The three Advantage plans in your evaluation

In Will County there are 49 Medicare Advantage plans, and the list of the Advantage plans with
the lowest costs for your drugs is in Appendix B2. The three plans in your evaluation all have
low costs for your two Rx drugs and have Dr. Marcheschi listed in their networks.

Before enrolling in an Advantage plan, it’s important to check with your doctor’s office to make
sure that she is still in the plan’s network. As you can see in Appendices A2, A3, and A4, Dr.
Marcheschi is listed in the three plans that are compared in your evaluation. Still, sometimes
the plans’ online provider directories are out of date, and you should verify that she will accept
the plan you’re enrolling in.

Once you’ve selected a plan, you can enroll by calling its toll-free number (shown on pages 2-3
of the evaluation). You should receive your enrollment card within a couple of weeks after you
call. And on your first visits to your doctors in August, show the office staff your Advantage plan
enrollment card to avoid any billing problems.

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