Page 14 - Cover letter and evaluation for Paulina Rosenstein

Medigap policies -- an overview

Frequently asked questions about Medigap policies

What is a Medigap policy? What are the most popular plans?
It's a standardized supplemental insurance
policy that fills some of the gaps in Medicare Plan F accounts for 40% of Medigap policies
coverage. There are 10 plans (see pp. 6-7). sold, followed by Plan C at 13%. Of the four
Medigap policies don't have network comprehensive plans that have higher cost
restrictions, so policyholders can see any
doctor who accepts Medicare. Also, sharing, Plan N is the most widely sold.
Medicare makes the coverage decisions, not
the insurance company. Are premiums based on my health?

Which plans have the best coverage? When you buy a policy during your initial six-
month open enrollment period, you cannot be

denied coverage or charged more because of
pre-existing conditions.

Plans C, D, F and G all have solid What are the open enrollment rules?

comprehensive coverage. But they are also Even though you will not be asked health

the most expensive plans, and their questions during your initial open enrollment

premiums (like those of other plans ) are period, insurance companies may adjust

expected to increase by between 3% and 4% premiums based on your age, gender, and

a year. That means that a 65-year-old who smoking status. After the initial six-month open
now pays $2,000 a year for a comprehensive enrollment period is past, in most states you
Medigap plan will pay about $4,400 a year at will have to answer health questions before you
age 85.
can get a premium quote.

People in good health might also consider Can I switch insurers and plans later?

one of the Medigap plans with higher cost- Yes, in many cases. And if your policy's

sharing -- Plans K, L, M, and N. Medicare now premiums increase by more than 4% a year, it
covers 100% of the cost of preventive
may be time to shop around. Still, it's probably
services, which reduces your risk with these not wise to switch policies for minor premium
plans. In particular, Plan L and Plan N are
savings, which may be the result of the timing
likely to save money for healthy people.
of insurers' increases.

Which plans have the most risk? Another point to keep in mind is that if you

Plans A and B both have coverage gaps of have health issues it may be more difficult

almost $13,000 for skilled nursing facility switch to another insurer. In most states you

care. For that reason, they are riskier than might look for an insurer that uses a modified

other Medigap plans. Plan K also has fairly community rating in pricing its Medigap

sizable risk, but unlike Plans A and B, it has policies. This type of rating sometimes makes it

an out-of-pocket limit that offers some easier for older people as well as those with

protection. Only two Medigap plans -- Plan K serious pre-existing conditions to get affordable

and Plan L -- have out-of-pocket limits. Medigap policies.

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