Page 2 - 2020 Cover Letter and Evaluation for Donna Yacoe

 If you decide to enroll in an Advantage plan, you can call the plan’s toll-free
number shown on pages 2-3 of the evaluation. Make sure that the person you
speak with understands that you want your coverage to begin on November 1.

 If you decide to get a Medigap policy and a Part D stand-alone plan, you should
first decide which Medigap plan you want – Plan G or N or another plan. Then
we suggest that you call three or more insurers before deciding which company
you’ll get your policy from.

 Finally, you can enroll in the Part D stand-alone plan that you choose by calling
the plan’s toll-free number shown on page 4 of the evaluation and in the Rx drug
coverage section below.

The two Medigap plans in your evaluation

Two of the four options compared in your evaluation are Medigap policies – Medigap Plan G
and Medigap Plan N. It might be helpful to review certain features that all Medigap policies
share (you may already be aware of these). Perhaps their most desirable feature is the
flexibility they offer. There are no networks, and you are covered when you see any provider
who accepts Medicare (as some 99% of doctors and public hospitals do). That means that you
can go to virtually any doctor, public hospital or clinic in the U. S. and be covered. All three of
your physicians accept Medicare payments, as shown in Appendix A, and so if you get a
Medigap policy you will be covered when you see them.

Another strength of Medigap policies is that Medicare, not the insurance company, makes the
coverage decisions. If Medicare approves a service or treatment, the Medigap insurer must also
cover it, up to policy limits. And because Medicare is more lenient than insurance companies,
Medigap policyholders may in some cases be covered for services and treatments that people
in Advantage plans may not be.

Medigap policies do not cover routine vision and dental care or hearing aids. Also, with the
exceptions of seldom sold Plan K and Plan L, they do not have out-of-pocket limits, although
that is rarely an issue because Medicare’s underlying catastrophic coverage is very good. And
some Medigap plans, including the two compared in in your evaluation, have some coverage
for foreign travel emergencies.

During the first six months that you are enrolled in Part B, you can get a Medigap policy without
answering questions about your health or disclosing pre-existing conditions. After this six-
month period has past, in Texas and most other states you will be medically underwritten
before you can get a policy or upgrade to a more comprehensive Medigap plan.

Many individuals, of course, wait to get their first Medigap policies until later retirement, but
there is a risk that if they have health problems when they apply, they will either pay higher
premiums or be declined coverage.

2