Page 3 - Cover letter and evaluation for Thomas Barr

Before choosing an insurance company to buy a Medigap policy from, it’s a good idea to get at
least three quotes and to choose a large company that has low premiums. Appendices B1
through B3 show the most recent premium comparisons from CSG Actuarial, with the lowest
premium companies listed first. You can use the comparisons as a starting point to identify the
companies that have lower premiums and then call those companies to get current quotes.

Appendix B4 is Medicare’s list of insurers that sell Medigap policies in Maryland, including their
telephone numbers (the CSG Actuarial premiums do not include telephone numbers). All the
companies in Appendix B4 sell Plan F, but not all of them sell the other two plans.

All your doctors accept Medicare assignment

In deciding which Medigap plan you might want, one factor to consider is whether your doctors
accept Medicare assignment. Providers who accept assignment have agreed to accept
Medicare-approved rates. And if they do not accept assignment, they can charge up to 15%
more. Plan F covers this additional 15% surcharge, but Plans N and L do not. In your case,
though, this isn’t an issue -- Appendix A shows the Medicare web site’s printouts indicating that
all five of your doctors accept assignment.

The Medicare Advantage plan in your evaluation

As the attachment to this letter shows, there are only 14 Medicare Advantage plans in Anne
Arundel County, eight of which are sponsored by Kaiser Permanente. As you may know, the
Kaiser Permanente plans require you to use their staff physicians, and so I didn’t consider these
as viable options (even though they are highly rated plans).

That leaves the six non-Kaiser Advantage plans -- four HMO’s and two PPO’s. I did not consider
the four HMO plans because of their high out-of-pocket limits and the fact that in these plans
you would likely need a referral each time you wanted to go to a specialist.

The two PPO plans are both new plans sponsored by Johns Hopkins Medicine. I chose to include
the Johns Hopkins MD PPO plan as one of your options, although I doubt that it is a very good
choice for you. One reason is its below-average 2.5-star Medicare quality rating, which means
that the plan’s overall performance is not well regarded by Medicare (and perhaps by plan
members). The ratings are a composite of almost 50 metrics that Medicare uses to assess plans’
clinical quality, their performance in giving patients Medicare’s recommended preventive tests,
customer satisfaction and so forth.

These ratings are an important measure of how well a plan is likely to perform (roughly 75% of
all Advantage plan enrollees are in plans rated four stars or higher). Because Johns Hopkins has
a stellar reputation for its medical care, the current low ratings are likely the result of the plan’s
being relatively new and still developing its internal processes. If this plan’s performance
improves in future years, during annual enrollment you could switch to this plan without

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