Page 2 - Evaluation for Norm Ross

Perhaps the most desirable attribute of Medigap policies is the flexibility they offer. You do not
need referrals to see specialists and you will be covered when you go to any provider who
accepts Medicare (as some 99% of doctors and public hospitals do). That means you can see
virtually any doctor in the U.S. or to any hospital or clinic and be covered. Because Medigap
policies are nationally standardized, your benefits and coverage are the same in every state.

Medigap policies do not include prescription drug benefits, and so if you choose to buy a
Medigap policy, you will also need to enroll in a Part D stand-alone drug plan, as discussed in
the Rx drug coverage section below. Also, Medigap policies do not cover routine dental and
vision care or hearing aids. Plans F and N include some benefits for medical emergencies while
traveling outside the United States (shown on pages 6-7).

Here are summaries of the three Medigap options compared in your evaluation. They are listed
in the order of their comprehensiveness, and their estimated annual premiums are for
someone your age who lives in Frederick County (you may be able to acquire a policy for
slightly less).

1) Medigap Plan F. This is the most comprehensive any Medigap plan, covering all of
Medicare’s gaps. That means that if you get Plan F, you will have no cost-sharing for
Medicare-covered services. Beginning in 2020, Plan F will no longer be sold, although
people who already own this plan may keep it. You can likely purchase a Plan F policy for
$2,300 a year (just over $190 a month).

2) Medigap Plan N. This is slightly less comprehensive than Plan F, and it has small
coverage gaps (pages 6-7 show where these gaps are). People in relatively good health
who don’t go to their doctors frequently will likely save $200-$300 a year in this plan
compared to choosing the higher-premium Plan F – even though in this plan you will
have small co-payments from time to time. Estimated premiums are $1,650 a year.

3) Medicare Plan L. This is the least comprehensive of the Medigap plans compared in
your evaluation. One desirable feature of this plan is its low $2,560 out-of-pocket limit –
it is the only Medigap plan in your evaluation that has an OOP limit. But the limit does
not include premiums and it applies only to the services the plan covers. As an example,
the Part B deductible ($183 in 2017) is not covered by this plan and so any money you
spend toward the deductible does not count toward the out-of-pocket limit. Annual
premiums for Plan L are about $1,550.

If you want to consider a less comprehensive Medigap plan like Plan L, the UnitedHealthcare
policies endorsed by AARP will likely permit you to later upgrade to a more comprehensive plan
without answering health-related questions. Some people choose one of the less
comprehensive Medigap plans sold by UnitedHealthcare (or UHC) – Plan N, for instance –
knowing that if they later want to upgrade to a different plan, they can do so without going
through underwriting. If that is something you want to consider, you should verify with UHC

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