Page 9 - Cover Letter and Cost Estimates for Ms. LaVerne Durham
P. 9
Plans that appear to meet your criteria (cont'd)
CareFirst BlueCross
Plan name Johns Hopkins BlueShield
Medigap Plan G Medigap Plan N Advantage MD Advantage Core
Plan (HMO)
Toll-Free Number Plan (HMO)
Estimated medical premiums for the full year (2021)
lity ratings from Medicare web site (best rating = 5 stars)
2021 Standard Part B
$1,782 $1,782 $1,782 $1,782
premium *
Health plan premiums
(Medigap premiums are $1,700 $1,350 $480 $240
estimates)
Total $3,482 $3,132 $2,262 $2,022
Minimum costs for Medicare-covered services
Total medical premiums $3,482 $3,132 $2,262 $2,022
(from above)
Plan health deductible
(includes Part B deductible $203 $203 $0 $0
if not covered by plan**)
Est. annual Rx drug
costs (premiums, $260 $260 $255 $351
deductibles, co-pays)
Total Minimum Costs
(includes cost-sharing for $3,945 $3,595 $2,517 $2,373
the Rx drugs you now take)
Cost-sharing for doctors office visits
=
In-Network Primary After Part B
Care Co-Pays No co-pays after deductible ($203) $5 $5
In-Network Specialist the annual Part B is paid, up to $20
co-payments for
Co-Pays deductible ($203) doctors' office $50 $50
Out-of-Network is paid visits and $50 for
Co-Pays ER visit. NA NA
*This is 2021 standard Part B premium for new enrollees is $148.50 a month; higher
income people may pay more. **Part B deductible in 2021 is $203.
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