Page 2 - Cover Letter & Evaluation for David Steenburgen

other three plans has an out-of-pocket limit. These are not the only good Medigap plans, of
course, but they are all relatively comprehensive and, except for Plan L, among the most
popular plans. Also, you may want to consider a Medicare Select plan, a type of Medigap policy
that has certain network restrictions. These plans are discussed later.

At the outset, it might help to review some features that all Medigap policies share (you may
already be aware of these). Medigap policies can be purchased during the first six months you
have Part A and Part B without having to answer health-related questions – although in Arizona
companies will adjust premiums for age, gender, and smoking status.

After that six-month period guaranteed-issue period is past, you will likely have to answer
questions about your health if you want to switch to another insurance company or 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 are the same in every state.

As for other benefits, Medigap policies do not cover routine dental and vision care or hearing
aids. Plans F, G, and N include some benefits for medical emergencies while traveling outside
the United States. Also, some plans do not cover what are known as “excess charges.” When a
doctor accepts Medicare assignment, he or she agrees to charge Medicare’s approved rates.
But when a doctor accepts Medicare but does not accept assignment, he or she can charge up
to 15% more than Medicare’s approved rates. Usually the exces charge is only a few dollars, but
occasionally it could be substantial.

Plans F and G in your evaluation cover this 15% excess charge but Plans N and L do not. Dr.
Sameshina accepts Medicare assignment, as indicated in Appendix A, and so when you see him
it should not be an issue. Benefit designs for all 10 Medigap plans are shown on pages 6-7. Here
are summaries of the four Medigap plans compared in your evaluation.

1) Medigap Plan F. This is the most comprehensive any Medigap plan, covering all of
Medicare’s gaps. Therefore in this plan your only cost for Medicare-covered services are
your premiums (Part B premiums and Medigap 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 Pima County you can likely purchase a Plan F policy for $2,450 a
year or less.

2) Medigap Plan G. This plan’s benefits are identical to Plan F’s except that Plan G does not
cover the Part B deductible ($183 in 2018). In many instances, people will save money
by choosing Plan G instead of Plan F because their premium savings are greater than the
Part B deductible. Beginning in 2020 when Plans F and C will no longer be sold, Plan G

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