Page 2 - Cover letter and evaluation for Paulina Rosenstein

Medicare (as more than 98% of doctors and public hospitals do). Because Medigap policies are
nationally standardized, your coverage is the same in every state.

There are certain benefits that Medigap policies do not cover – among these are prescription
drugs, routine dental and vision care and hearing aids. As we discussed, if you can get coverage
for dental and vision care through your husband’s employer plan, that will likely be your best
option. Otherwise you will need to purchase unsubsidized coverage on the open market or self-
insure. On page 10 of your evaluation, the different kinds of dental and vision coverage are
explained.

Although Medicare does not provide coverage when you are outside the United States,
Medigap Plans F, G, and N include some benefits for medical emergencies while traveling in
other countries. You can see a description of this coverage on pages 6-7 of the evaluation.

Also, some Medigap plans do not cover what are known as “excess charges” from providers
who do not accept Medicare’s approved rates as payment in full. As an example, a doctor may
accept Medicare patients but not agree to accept Medicare’s approved rates. In that case, the
doctor can charge up to 15% more than the approved rates. Plans F and G in your evaluation
cover these excess charges, but Plans N and L do not. Typically these excess charges are only a
few dollars, but in isolated cases they can be substantial.

If you give me the names of your doctors, their office zip codes and specialties, I can check the
Medicare provider directory to see whether they have agreed to accept the approved rates
(doctors that have agreed are said to “accept Medicare assignment”). But if you choose Plan F
or Plan G, these excess charges will be covered and your only question will be whether a
provider accepts Medicare.

Here are brief descriptions of the four plans compared on pages 2-3 of the evaluation:

1) Medigap Plan F. This is the most comprehensive any Medigap plan, covering all of
Medicare’s gaps. 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 your zip code, you can likely purchase a Plan F policy for $3,700 a year or
slightly 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
will be the most comprehensive Medigap plan. Your annual premiums in this plan will
likely be about $3,500.

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