Page 2 - Cover Letter and Evaluation for Paul Howell

you’ll get your policy from. You can find the phone numbers of the companies
that sell Medigap policies in Tennessee in Appendix B1. To enroll in the lowest-
cost Part D stand-alone plan, call the plan’s toll-free number shown on page 4 of
the evaluation and in the Rx drug coverage section below.

Tennessee’s Medigap premiums for people younger than 65

In Tennessee, insurance companies that sell Medigap policies are required to sell those policies
to people younger than 65 during the first six months that those individuals have Part B. This
six-month period is sometimes referred to as a “guaranteed issue” period. After that six-month
period is past, you may have difficulty in getting a Medigap policy.

Your only opportunity, then, to get a Medigap policy before you turn 65 is probably during the
first six months that you have Part B. When you turn 65 in 2026, you will get a new six-month
guaranteed issue period, and Medigap premiums will be much lower than they are for people
younger than 65.

Even though you will be able to get a Medigap policy during the six-month period beginning
May 1, you will pay much higher premiums than you would if you were 65. The least expensive
Medigap Plan G policy, as shown in Appendix B2, is $271 a month – or more than $3,200 a year
– and that does not include Part B premiums or costs for prescription drugs.

Attached to this letter is an explanation of Tennessee’s requirements regarding the sale of
Medigap policies to people younger than age 65.

The basics of Medigap coverage

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 A1, and so if you get a Medigap policy you will be covered
when you see them.

Medigap policies do not cover routine vision and dental care or hearing aids. And 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. Some
Medigap plans, including the two compared in in your evaluation, include coverage for foreign
travel emergencies.

The benefit designs of the 8 Medigap plans available to you are shown on pages 6-7.
Here are summaries of the two plans compared in your evaluation.

2