Page 2 - Cover Letter and Evaluation for Steve Decker

 If you decide to get a Medigap policy and a Part D stand-alone plan, you should
first decide which Medigap plan you want – Medigap Plan G or Medigap Plan N
or another plan. Then it’s a good idea to call three or more insurers and get
current quotes before deciding which company you’ll get your policy from.

 To enroll in the Part D stand-alone plan that has the lowest costs for your Rx
drugs, calling the plan’s toll-free number, which is shown on page 4 of the
evaluation and in the Rx drug coverage section below.

The two Medigap plans in your evaluation

Two of the four options compared in your evaluation are Medigap policies – Medigap Plan G
and Medigap Plan N. It might be helpful to review certain features that all Medigap policies
share (you may already be aware of these). Perhaps their most desirable feature is the
flexibility they offer. There are no networks, and you are covered when you see any provider
who accepts Medicare (as some 99% of doctors and public hospitals do).

With a Medigap policy, then, you can go to virtually any doctor, public hospital or clinic in the
United States and be covered. Your four physicians all accept Medicare, as shown in Appendix
A1, but Dr. Dores, your dentist, is not listed. Since Medicare does not cover dental care, dentists
are rarely listed in the Medicare provider directory.

Another strength of Medigap policies is that Medicare, not the insurance company, makes the
coverage decisions. And if Medicare approves a service or treatment, the Medigap insurer must
also cover it, up to policy limits. Because Medicare is more lenient in approving certain
treatments than are insurance companies, Medigap policyholders may in some cases be
covered for those treatments when people in Advantage plans may not be (the insurance
company might say that the treatment is not medically necessary). For that reason, people with
health issues typically choose to get a Medigap policy if they can afford its higher premiums.

Medigap policies do not cover routine vision and dental care or hearing aids, none of which are
covered by Medicare. Also, with the exceptions of seldom sold Plan K and Plan L, they do not
have out-of-pocket limits, but that is rarely an issue because Medicare’s underlying catastrophic
coverage is strong. And some Medigap plans, including the two compared in your evaluation,
include coverage for foreign travel emergencies.

Connecticut is one of four states that requires Medigap policies to be a) community rated,
without regard to age, gender, or health status and b) sold on a guaranteed issue basis, as
explained in Appendix B1. Therefore, someone can wait until later retirement to buy his or her
first Medigap policy without having to worry about being denied coverage or paying higher
premiums due to health problems or serious pre-existing conditions.

While the community rating and guaranteed issue requirements give people with more
flexibility, they also result in higher premiums, especially for younger beneficiaries.

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