Page 12 - Cover Letter and Medicare Evaluation for Andrea Masters

Plans that appear to meet your criteria

These four plans are compared on this page and the following page

CDPHP $0 Highmark Blue
Plan Name Medigap Plan G Medigap Plan N Medicare Rx HMO Shield Freedom
Plan Nation PPO Plan

Toll-Free Number NA NA (888) 519-4455 (888) 875-2232
QuaSection Heading How do these plans compare?
lity ratings from
Can you continue to see
your physician(s)? Yes Yes Yes, but verify Yes, but verify

Do you need referrals to
see specialists? No No Yes, in most cases No
Medicare does not Medicare does not
Medicare's quality rating rate Medigap rate Medigap 5 out of 5 stars 5 out of 5 stars
policies policies
$7,550 in network;
Excellent. It does Excellent. It does
How good is the plan's not have an out-of- not have an out-of- $7,500, which is $11,300 in and out-
catastrophic coverage? pocket limit, pocket limit, below average of-network, which
is below average
though though
for a PPO
$360 a day for days $375 a day for days
How much does a hospital 1-5 in network 1-5 in network;
stay cost? $0 $0 hospital; $0 for 50% out-of-
days 6-90 network

Benefits for services not covered by Medicare

Preventive services
Some benefits;
Routine dental care Not covered Not covered $15; supplements
limits apply
available

$20 for routine eye $25 for routine eye
exam; $0 for exam; $0 for
Routine vision care Not covered Not covered
eyeglasses or eyeglasses or
contacts contacts

$40 co-pay for $36 co-pay for
Hearing benefits Not covered Not covered
hearing exam hearing exam

After $250 After $250
Foreign travel deductible, 80% of deductible, 80% of Some coverage Some coverage
emergencies costs ($50,000 costs ($50,000
lifetime limit) lifetime limit)

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