Page 3 - Cover letter and evaluation for Marcelle Nesci

On the minus side, this flexibility makes Medigap policies in New York among the most
expensive in the country. In most other states, insurers can deny coverage to sick people who
have been enrolled in Part B for more than six months, and that helps to keep premiums under
control. New York’s Medigap open enrollment rule is explained in Appendix B1.

The three Medigap plans in your evaluation

Before summarizing the Medigap plans in your evaluation, it might be helpful to review certain
features that all Medigap policies share (you may already be aware of these). Perhaps their
most desirable 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).
And so you can go to virtually any doctor, public hospital or clinic in the U. S. and be covered.

Another strength is that Medicare, not the insurance company, makes the coverage decisions.
If Medicare approves a service or treatment, the Medigap insurer must also cover it, up to
policy limits. And because Medicare is more lenient than are insurance companies, Medigap
policyholders may in some cases be covered for services and treatments that people in
Advantage plans may not be.

Neither Medicare nor Medigap policies cover routine dental and vision care or hearing aids. The
three Medigap plans compared in your evaluation do include benefits for medical emergencies
while traveling outside the United States (as shown on pages 6-7).

Here are summaries of the three Medigap plans compared in your evaluation. They are listed in
the order of their comprehensiveness.

1) Medigap Plan F. This is the most comprehensive Medigap plan, covering all of
Medicare’s gaps. If you get Plan F, then, you will have no cost-sharing for Medicare-
covered services. The potential long-term downside of Plan F is that it will no longer be
sold beginning in 2020, although people who already have this plan may keep it. Some
analysts think that as its number of policyholders gradually declines, Plan F's premiums
will rise more quickly. But that should not be an issue in New York since you can always
change to a different plan. You can likely get a Plan F policy for roughly $3,000 a year or
perhaps less.

2) Medigap Plan G. This plan’s benefits are identical to those of Plan F except that it does
not cover the Part B deductible, which in 2019 is $185. In some cases, people can save
money by choosing Plan G instead of Plan F because the premium savings are greater
than the amount of the Part B deductible. I’ve estimated that you can get Plan G for
$2,800 a year, or about $200 less than Plan F.

3) Medigap Plan N. This is a slightly less comprehensive plan than Plans F and G and it has
some small gaps (pages 6-7 show where these gaps are). People in relatively good

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