Page 2 - Cover letter and evaluation for Darlene Hoover

decision. And Medicare is much more likely to approve some types of treatments than are
insurance companies.

Medigap policies are standardized and their benefit designs rarely change. Because the benefits
are the same regardless of the insurance company you buy your policy from, you can focus on
premiums. Advantage plans, in contrast, often change their benefit designs from one year to
the next.

The two Medigap plans in your evaluation are among the less comprehensive (and less
expensive) of the 10 plans. Over time, people in good health who do not go their doctors
frequently or undergo expensive treatments can save substantial amounts in less
comprehensive Medigap plans because their premium savings outweigh the additional co-
payments they will make. There is somewhat more risk in a less comprehensive Medigap plan,
but neither of the two plans compared in your evaluation has large gaps.

Medigap policies do not cover prescription drugs, and so you will also need to enroll in a Part D
stand-alone drug plan. Neither do Medigap policies cover routine dental and vision care or
hearing aids (although the two Advantage plans in your evaluation have some dental and vision
benefits, including supplemental packages you can purchase for an extra premium). See page
10 of the evaluation for more information on buying a dental or vision plan.

The benefit designs for all 10 Medigap plans are shown on pages 6-7. Here are summaries of
the two Medigap plans in your evaluation.

1) Medigap Plan N. While this plan has some coverage gaps, they are small ones. It does
not cover the Part B deductible, which will be $185 in 2019, and it requires co-payments
of up to $20 for a doctor’s office visit (and $50 for an emergency room visit). In the Fort
Wayne area, this plan’s annual premiums are roughly $400 less than those of Plan F,
which is the most comprehensive Medigap plan and the only Medigap plan that covers
all of Medicare’s gaps.

In 2019 after you’ve spent the $185 Part B deductible, a doctor’s office visit will require
a co-payment of up to $20 if you have Plan N. During the year if you have five doctor’s
office visits after you’ve met the deductible, your total cost-sharing would be $285
($100 in co-payments plus the $185 Part B deductible). In this example, assuming your
Plan N premiums were $400 less than those of Plan F, you’d come ahead by $125 or so.
And if you went to your doctors ten times after you’d satisfied the Part B deductible,
you’d probably come close to breaking even. In Allen County you can likely purchase a
Plan N policy for $1,100 a year or thereabouts (the evaluation assumes you’ll pay
$1,125).

2) Medigap Plan L. This is one of two Medigap plans that has an out-of-pocket (or OOP)
limit for medical services (not including Part D costs). In 2019, the OOP limit is $2,780.
As you may know, a plan’s OOP limit does not include premiums and applies only to the

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