Page 2 - Cover Letter and Medicare Evaluation for Neill McLauchlin

b) After deciding which Medigap plan you want, call two or three companies
and then get your policy from a company that has low premiums. You can
see each insurance company’s premiums for Plan G in Appendix B1 and for
Plan N in Appendix B2. It’s possible that some of these premiums are out of
date, and so you should call to get current quotes. The companies’ phone
numbers are in Appendix B3. And when you do get a policy, specify a June 1
start date.

c) You will also need to enroll in a stand-alone drug plan. Your evaluation
includes the phone number of the stand-alone drug plan that has the lowest
costs for the Rx drugs that you take. When you call, let the plan know you
want your coverage to begin on June 1.

2) A Medicare Advantage plan. These are managed-care plans, primarily HMO’s and
PPO’s, and they include prescription drug coverage. You can enroll in an Advantage
plan by calling its toll-free number, shown in your evaluation.

The two Medigap plans compared in your evaluation

There are eight Medigap plans you can choose among, each with a slightly different set of
benefits. As mentioned, the two Medigap plans in your evaluation are Plan G and Plan N, which
are briefly described below.

Probably the best feature of Medigap policies is that you will be covered when you go to
virtually any doctor or medical provider in the United States. With Medigap policies, there are
no networks, and you don’t need referrals to see specialists.

Medigap policies’ downside is that they are expensive, especially over a long period of time.
One reason they’re expensive is that their coverage is comprehensive, and with a Medigap
policy you will have relatively few co-payments compared to an Advantage plan.

The two Medigap plans compared in your evaluation – Plan G and Plan N – are both
comprehensive. In either of these plans, after you’ve paid the $203 Part B deductible, you
won’t have many (or any in Plan G) co-payments for the services that Medicare covers.

Another strength of Medigap policies is that Medicare, and not an insurance company, makes
the coverage decisions. And if Medicare approves a service or treatment, the Medigap insurer
must also cover it, up to policy limits. Because Medicare is more lenient in approving certain
treatments than are insurance companies, Medigap policyholders may in some cases be
covered for treatments that people in Advantage plans may not be (the Advantage plan could
say that the treatment is not medically necessary). For that reason, people with pre-existing
conditions will typically get Medigap policies if they can afford them.

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