Page 4 - Questionnaire

D: Do you prefer a certain type of coverage?

If you do not have an employer plan to supplement Medicare, you will need either a Medigap

policy or a Medicare Advantage plan. Do you have a preference or would you like to see
comparisons of both types? Medigap polices don’t have networks and are typically more

expensive. Advantage plans are managed care plans like HMO’s and PPO’s.

 I’d like to see comparisons of both of these types of coverage

 I’m only interested in Medigap policies  I’m only interested in Advantage plans

Also, please send us your employer plan’s benefit summary, including premiums, so that we

can compare it to your Medicare choices.

______________________________________________________________________________
E: Engagement terms

The cost of a comparison of your current employer plan and your Medicare options is $200.
These comparisons rely on information from Medicare and state insurance departments. Dover
Healthcare Planning, LLC, believes this information to be accurate but is not responsible for its
accuracy.

Please initial here to indicate that you agree to the engagement terms: ________

D o v e r H e al t hcar e P l anni ng, L L C Page 4