Page 2 - Cover letter and evaluation for Marcelle Nesci

your policy from, you can enroll on the phone – again specifying that you want
your coverage to begin on March 1.

 Finally, you can enroll in the Part D stand-alone plan that you choose by calling
the plan’s toll-free number shown on page 4 of the evaluation.

Your physicians’ network affiliations

All your doctors accept Medicare-approved rates, as shown in Appendix A. For future reference,
some doctors who accept Medicare do not accept Medicare-approved rates. In those cases,
they can charge up 15% more than the approved rates. Usually that turns out to be a few
dollars, although for expensive treatments it can be more substantial. Medigap Plans F and G in
your evaluation cover the added charge but Plan N does not. Since your current doctors accept
approved rates, this isn’t an issue.

I was unable to find a Medicare Advantage plan whose network includes all your doctors, as
shown on the attachment to this letter. As mentioned, sometimes the online provider
directories that we rely on are out of date, and so before enrolling in an Advantage plan you
should verify with your doctors’ offices whether they accept the plan that you want to enroll in.

Drs. Trapasso and Gao are both listed in the network of the Advantage PPO plan that’s
compared in your evaluation. It’s possible, of course, that one or more of your other doctors is
in this plan’s network, in case you want to check with their offices. Nationally, less than 50% of
doctors belong to an Advantage plan network, although that percentage can vary widely from
one area to another. In an Advantage PPO plan like the one in your evaluation, you will be
covered when you go outside the network but will have higher cost-sharing.

The state of New York’s Medigap open enrollment rule

New York’s Medigap rules enable people with Medicare to get a Medigap policy at any time
without having to answer health-related questions or disclose pre-existing conditions. That’s
not the case in most other states, where if you’ve had Part B for more than six months you can
be denied coverage or charged higher premiums if you have health issues.

In addition, in New York policies cannot be age-rated, so that a 65-year-old and a 90-year-old
pay the same premiums (although the premiums vary from one insurer to another). These
consumer protections come with pluses and minuses.

On the plus side, you can wait until later retirement to get your first Medigap policy without
worrying about being denied coverage or paying higher premiums because of a pre-existing
condition. You can also buy a less comprehensive (and less expensive) Medigap plan in early
retirement and then in later retirement can upgrade to a more comprehensive plan without
worrying about being denied the upgrade.

2