Page 9 - Cover letter and evaluation for Jay Newman
P. 9
Plans that appear to meet your criteria (cont'd)
Plan name Medigap Plan F Medigap Plan G Medigap Plan N Medigap Plan L
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 $3,500 $3,300 $2,625 $2,400
premiums are estimates)
Total $5,108 $4,908 $4,233 $4,008
Minimum costs for Medicare-covered services
Total medical premiums
(from above) $5,108 $4,908 $4,233 $4,008
Plan health deductible
(includes Part B deductible if $0 $183 $183 $183
not covered by plan**)
Annual Rx costs for
monthly refills at CVS $223 $223 $223 $223
(premiums and co-pays)
Total Minimum Costs
(includes cost-sharing for the $5,331 $5,314 $4,639 $4,414
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
In-Network Specialist Medicare-covered Medicare-covered Medicare-approved 5% of Medicare-
doctor's visit; $50
Co-Pays services services for emergency approved cost
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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