Page 2 - Cover Letter and Evaluation for Dr. Maury Rosenstein

Medigap policies can be purchased during the first six months you have Part B without your
having to answer health-related questions. After that six-month period has past, in most states
if you want to acquire a Medigap policy, you will likely have to answer questions about your
health before receiving a premium quote. In your home state of New York, however, residents
can get a Medigap policy at any time without answering health-related questions or disclosing
pre-existing conditions, as described in Appendix B4.

Neither Medicare nor Medigap policies cover routine dental and vision care or hearing aids.
Plans F, G, and N in your evaluation do include some benefits for medical emergencies while
traveling outside the United States (as shown on pages 6-7 of the evaluation).

Below are brief summaries of the four Medigap plans compared in your evaluation – Plan F,
Plan G, Plan N, and Plan L. You can see each plan’s coverage gaps on pages 6-7 of the
evaluation. Plans N and L are not good choices for you at this point because you are planning to
have surgery. But I thought I’d include them so that you can see a wider range of choices than
one or two plans, and perhaps they will be helpful for future reference.

1) Medigap Plan F. This is the most comprehensive Medigap plan, covering all of
Medicare’s gaps. With Plan F, then, you have no cost-sharing for Medicare-covered
services – your only costs for Medicare services are your premiums (Medigap and Part
B). Beginning in 2020, Plan F (as well as Plan C) will no longer be sold, although
policyholders who already have this plan at that time may keep it. In Charleston, annual
premiums for someone your age are in the $1,750 range, although you can probably get
a policy for 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
$1,550 a year, or roughly $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
health who don’t go to their doctors frequently will likely save $200-$300 a year in this
plan compared to choosing the higher-premium Plan F. For Plan N, estimated annual
premiums are $1,350.

4) Medicare Plan L. This is the least comprehensive of the four Medigap plans compared in
your evaluation. One good feature of Plan L is its low $2,780 out-of-pocket limit – it is
the only Medigap plan in your evaluation that has an OOP limit. But the limit does not
include premiums and applies only to the services the plan covers. As an example, the
Part B deductible is not covered by this plan and so any money you spend on the
deductible will not apply to the out-of-pocket limit. Annual premiums for Plan L are
about $1,275.

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