Page 8 - Cover Letter and Cost Estimates for Ms. LaVerne Durham

Plans that appear to meet your criteria

These four plans are compared on this page and the following page

CareFirst BlueCross
Plan Name Johns Hopkins BlueShield
Medigap Plan G Medigap Plan N Advantage MD Advantage Core
Plan (HMO) Plan (HMO)
Toll-Free Number
QuaSection Heading How do these plans compare?
lity ratings from
Can you continue to see Three of your Two of your
your physician(s)? Yes Yes doctors are not doctors are not
listed in network listed in network
Do you need referrals to

see specialists? No No Yes Yes
Medicare does not Medicare does not
Medicare's quality rating rate Medigap rate Medigap 3.5 out of 5 stars Plan too new to be
measured
policies policies

Excellent. It does Excellent. It does
How good is the plan's not have an out-of- not have an out-of- Poor for HMO. Poor for HMO.
catastrophic coverage? pocket limit, pocket limit, $7,550 for network $7,550 for network
services.
services.
though though
$310 a day for days $350 a day for days
How much does a hospital 1-5 in network 1-5 in network
stay cost? $0 $0 hospital; $0 for hospital; $0 for
days 6-90. days 6-90.
Benefits for services not covered by Medicare

$15 for oral exam; $30 co-pays for
$15 for teeth oral exam, teeth
Routine dental care Not covered Not covered
cleaning; $25 for x- cleaning, and x-
rays rays
No-cost eye exam, $20 for routine eye
Routine vision care Not covered Not covered glasses and/or exam and eyeglass
contacts lenses

$50 co-pay for $40 co-pay for
Hearing benefits Not covered Not covered
hearing exam hearing exam

After $250 After $250
Foreign travel deductible, 80% of deductible, 80% of Not covered Some coverage
emergencies costs ($50,000 costs ($50,000
lifetime limit) lifetime limit)

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