Page 13 - Cover Letter and Evaluation for Melanie
P. 13

Plans that appear to meet your criteria (cont'd)



                         Plan name     Medigap Plan F     Medigap Plan C     Medigap Plan G     Medigap Plan N


                 Toll-Free Number           NA                 NA                 NA                 NA

                         Estimated annual premiums for medical coverage
          lity ratings from Medicare web site (best rating = 5 stars)
             2018 standard Part B

                premium of $134 a          $1,608             $1,608             $1,608             $1,608
                            month*

                 Health plan annual
                 premiums  (Medigap        $1,900             $1,860             $1,700             $1,450
               premiums are estimates)

                              Total        $3,508             $3,468             $3,308             $3,058

                            Minimum costs for Medicare-covered services


           Total medical premiums
                         (from above)      $3,508             $3,468             $3,308             $3,058

             Plan health deductible

           (includes Part B deductible if    $0               $183               $183                $183
                 not covered by plan**)

               Annual Rx costs for
             monthly refills at CVS        $1,547             $1,547             $1,547             $1,547
                (premiums and co-pays)
             Total Minimum Costs

           (includes cost-sharing for the   $5,055            $5,198             $5,038             $4,788
                 Rx drugs you now take)

                                  Cost-sharing for doctors office visits
                                                                    =
            In-Network Primary
                Care Co-Pays                                                                     up to $20 for
                                                                             No co-pays for
                                       No co-pays for
                                                          No co-pays for
           In-Network Specialist      Medicare-covered  Medicare-covered  Medicare-covered    Medicare-approved
                                                                                               doctor's visit; $50
                   Co-Pays                services           services           services        for emergency
              Out-of-Network                                                                      room visit
                   Co-Pays

          *This is 2018 Part B premium for new enrollees. Higher income people may pay more.
          **Part B deductible in 2018 is $183.



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