Page 2 - Cover Letter and Evaluation for Patti Messerschmitt

 You will also need to enroll in a Medicare prescription drug plan (stand-alone
drug plan), but you should wait to enroll until you know whether your insulin
pump will be covered by Medicare. If it will be, then your insulin will also be
covered. But if it turns out that your insulin pump is not covered by Medicare,
then I’ll look for the drug plans are least expensive for insulin as well as your
other three drugs.

The two Medigap plans in your evaluation

Plan G and Plan N are the two Medigap plans compared in your evaluation. John currently has
Plan F, which is the most comprehensive of the Medigap plans, but that plan is not available to
you. A recent law prevents people who turn 65 in 2020 or later from getting Plan F or Plan C.

With a Medigap policy, you will be covered when you go to virtually any doctor, public hospital,
or clinic in the United States, since more than 99% of providers accept Medicare. As shown in
Appendix A, Dr. Truong accepts Medicare. Medigap policies do not cover dental care or routine
vision care, neither of which is covered by Medicare. But they do cover diseases of the eye –
cataracts, glaucoma, etc.

One strength of Medigap policies is that Medicare (and not an 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.

Appendix B1 has the California Department of Insurance listings of each insurance company’s
Medigap premiums as well as the companies’ phone numbers. Some of these premiums may be
out of date, and so it is important to call the companies to get current quotes.

Appendices B2 and B3 show the premiums that are listed by CSG Actuarial, a firm that provides
quotes for insurance agents. While these premiums should be current, in a few cases they may
not include the agents’ commissions (there’s no way for me to know which ones these are). The
companies’ phone numbers are shown in Appendix B1.

Here's a snapshot of the two Medigap plans compared in your evaluation:

1) Medigap Plan G. As mentioned, this is a comprehensive plan that covers all of
Medicare’s medical gaps Medicare except for the Part B deductible, which this year is
$198. That means that after you have satisfied the Part B deductible you will not have
any co-payments or other cost-sharing for Medicare-covered services for the remainder
of the year. Premiums vary widely (as you can see in the appendices). For Plan G, you
should be able to get a policy for about $1,600 a year or slightly less.

2) Medigap Plan N. This plan is less comprehensive than Plan G but is still solid coverage.
Its gaps include the $198 Part B deductible, co-pays of up to $20 for doctor’s office
visits, and a $50 co-pay for emergency room visits. Annual premiums are roughly 20%

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