Page 2 - Evaluation and cover letter for Jack Barnhill

After that six-month period guaranteed-issue period is past, you will likely have to answer
questions about your health before you can get a Medigap policy or – if you already have one --
upgrade to a more comprehensive Medigap plan.

Perhaps the most desirable attribute of Medigap policies is the flexibility they offer. You do not
need referrals to see specialists and will be covered when you see any provider who accepts
Medicare (as more than 98% of doctors and public hospitals do). Because Medigap policies are
nationally standardized, your benefits and coverage are the same in every state.

If you get a Medigap policy, you will need to enroll in a Part D stand-alone drug plan. Also,
Medigap policies do not cover routine dental and vision care or hearing aids. Plan F includes
some benefits for medical emergencies while traveling outside the United States. 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 F. This is the most comprehensive any Medigap plan, covering all of
Medicare’s gaps. That means you will not have any cost-sharing for Medicare-covered
services and that your entire cost for these services will be in your premiums. Beginning
in 2020, Plan F (and Plan C) will no longer be sold, although people who already own this
plan at that time may keep it. In Orange County you can likely purchase a Plan F policy
for $2,350 a year or less.

2) Medigap Plan L. This is a less comprehensive plan. One of its nice features is its low
$2,620 out-of-pocket limit – it is one of only two Medigap plans that have an OOP limit.
But the limit does not include premiums and applies only to the services the plan covers.
As an example, the Part B deductible ($183 in 2018) is not covered by this plan and so
any money you spend toward the deductible will not apply to the out-of-pocket limit.
Annual premiums for Plan L for a man your age are roughly $1,600, although you may
be able to purchase a policy for less. In California few insurers sell this plan, but based
on the premiums shown in the appendices, you will likely come out $200-$300 ahead of
what you’ll pay in Plan F premiums.

There are other good Medigap plans, of course. Plan G’s benefits are similar to those of Plan F,
the only difference being that Plan G does not cover the Part B deductible ($183 in 2018).
Therefore if you can save more in premiums than the amount of the Part B deductible, you
come out ahead. Plan N is also a popular choice, and (like Plan L), if you do not go to your
doctors frequently or have expensive medical treatments, you will likely save money compared
to what you’ll pay in Plan F premiums.

Medicare assignment

Both of your physicians accept Medicare assignment, as shown in Appendix A. When a doctor
accepts Medicare but does not accept assignment, he or she can charge up to 15% more than
Medicare-approved rates. Typically these excess charges are a few dollars, although in the case

2