Page 2 - Cover Letter and Evaluation for Sue Marx

Moving your coverage to another state

Medicare has several protections for people who move to another state, as follows:

If you initially enroll in an Advantage plan in Pennsylvania: you will have a guaranteed
right to switch to another Advantage plan when you move out of the plan’s service area.
And you will also have a right to get certain Medigap plans without answering health-
related questions. These rights are good for 63 days from the date that you move.

If you initially get a Medigap policy and a Part D stand-alone plan In Pennsylvania: your
Medigap coverage is good anywhere in the United States. So, you can keep your policy in
the state that you move to, although your premiums may be adjusted. After you’ve moved
if you want to switch to a Medicare Advantage plan, you will likely need to wait until
Medicare’s annual open enrollment period (October 15 through December 7). And if the
Part D stand-alone plan that you signed up for in Pennsylvania is a national plan, you will
probably be able to keep it after you move. If it is not a national plan, you have a right to
switch to a different stand-alone drug plan within two months after moving.

Explanations of these rules are attached to this letter.

The two Medigap plans in your evaluation

Two of the four options that are compared in your evaluation are Medigap policies. It might be
helpful to review certain features that all Medigap policies share (you may already be aware of
these). Perhaps their most desirable feature 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). That means that you can go to virtually any doctor, public
hospital or clinic in the U. S. and be covered.

Another strength of Medigap policies 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 insurance companies,
Medigap policyholders may in some cases be covered for services and treatments that people
in Advantage plans may not be.

Medigap policies do not cover routine vision and dental care or hearing aids. Also, with the
exceptions of seldom sold Plan K and Plan L, they do not have out-of-pocket limits, although
that is rarely an issue because Medicare’s underlying catastrophic coverage is very good. And
some Medigap plans, including the two that are compared in in your evaluation, have some
coverage for foreign travel emergencies.

During the first six months that you are enrolled in Part B, you can get a Medigap policy without
answering questions about your health or disclosing pre-existing conditions, as explained in

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