Page 10 - Cover Letter and Evaluation for Bob Workman

Plans that appear to meet your criteria

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

Humana Choice
Medigap Plan N
Plan Name Medigap Plan F Medigap Plan K Advantage PPO
(Your Current Plan)
(H5216-046)
Toll-Free Number NA NA NA (800) 833-2364
QuaSection Heading How do these plans compare?
lity ratings from

Can you continue to see Yes, but verify that
your physician(s)? Yes Yes Yes Dr. Miranda is in
network

How large is the plan's You can see any You can see any You can see any More than 20,000
provider who
provider who
provider who
provider network? accepts Medicare accepts Medicare accepts Medicare providers
Do you need referrals to
see specialists? No No No No

50% of the Part A
What is the potential cost No cost for No cost for deductible of $275 a day for days
of a hospital stay? Medicare-covered Medicare-covered $1,316 (you pay 1-5; nothing
hospital services hospital services thereafter
$658)

How good is the plan's Excellent. It does Excellent. It does Fair. $5,120 out-of- Good for PPO.
pocket limit for
catastrophic coverage for not have an out-of- not have an out-of- services the plan $3,600 in network
and $4,500 in and
pocket limit,
pocket limit,
medical care? though though covers out of network.

What are Medicare's Medigap policies Medigap policies Medigap policies
ratings for this plan? are not rated by are not rated by are not rated by 4 stars
Medicare Medicare Medicare

Benefits for services not covered by Medicare

Available for added
Routine dental care Not covered Not covered Not covered
premium

Routine vision care Not covered Not covered Not covered Not covered

After $250 After $250
deductible, 80% of deductible, 80% of
Foreign travel emergencies Not covered Not covered
costs ($50,000 costs ($50,000
lifetime limit) lifetime limit)

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