Page 2 - Cover letter and Medicare evaluation for Hans Burkhardt

How do Medigap policies work?

It might help to review some features that all Medigap policies share. The most important thing
to be aware of is that during the first six months that you have Part B, you can get a Medigap
policy without having to answer health-related questions. But after that six-month period is
past, in California and most other states you will have to answer questions about your health
before you can get a Medigap policy. And individuals with serious pre-existing conditions may
not be able to get a Medigap policy after the initial six-month guaranteed-issue period is over.

Perhaps the most desirable attribute of Medigap policies is the flexibility they offer. There are
no networks, and you do not need referrals to see specialists. You will be covered when you see
any provider who accepts Medicare (as more than 99% of doctors and public hospitals do).

When you have a Medigap policy and go to a doctor or other medical provider, he or she will
send the bill for your visit to Medicare. Then Medicare pays the doctor what it owes – usually
80% -- and forwards the 20% balance to the Medigap insurance company that issued your
policy. After the Medigap insurer pays the doctor some or all of the 20% balance, the doctor
will then send you a bill for any remaining amount that was not paid either by Medicare or the
Medigap insurance company.

One nice feature of this kind of coverage is that Medicare makes the coverage decisions, and
not an insurance company. When Medicare pays for a medical service or treatment, the
Medigap insurer is also required to pay. That’s different from an Advantage plan, where the
insurance company can in some cases decide whether a service will be covered.

Since Medigap policies cover you when you go to any doctor who accepts Medicare, they are
the best option for people like you who will soon re-locate or who travel within the U. S. often
or who have a vacation home in another area.

Moreover, if you plan to travel to other countries, the two Medigap plans in your evaluation
both include some coverage for medical emergencies when you’re traveling abroad. This
coverage has a $250 deductible, after which the Medigap policy will pay 80% of the cost, with a
$50,000 lifetime limit.

Comparing the two Medigap plans

The two Medigap plans compared in your evaluation – Plan G and Plan N – are similar, and they
are two of the most popular plans. Here are brief summaries of these two plans:

1) Medigap Plan G. This is the most comprehensive Medigap plan available to people who
turned 65 in 2020 or later. It covers all of Medicare’s gaps except for the annual Part B
deductible, which is $203 this year. That means that once you’ve paid the Part B
deductible, you will not have any further cost-sharing for Medicare-covered services. In

2