Page 10 - Cover Letter and Medicare evaluation for Mr. Rod Fallow

Plans that appear to meet your criteria

These four plans are compared on this page and the following page

UHC Medicare
Ava Advantage
Plan Name Medigap Plan G Medigap Plan N Advantage Assure
HMO Plan
HMO Plan

Toll-Free Number NA NA (888) 979-2247 (800) 555-5757
QuaSection Heading How do these plans compare?
lity ratings from

Can you continue to see Dr. Vesuna is listed Dr. Vesuna is listed
your physician(s)? Yes Yes in this plan's in this plan's
network
network
Do you need referrals
to see specialists? No No Yes Yes

Medicare's quality Medicare does not Medicare does not
rating rate Medigap rate Medigap 4 out of 5 stars 4 out of 5 stars
policies
policies
Excellent. It does Excellent. It does Excellent. $1,999
How good is the plan's not have an out-of- not have an out-of- OOP limit for Poor for HMO plan.
$7,550 for medical
catastrophic coverage? pocket limit, pocket limit, medical services in services in network
though though network

$0 for days 1-4 in
How much does a network hospital;
hospital stay cost? $0 $0 $100 a day for days $1,480 per stay
5-10
Benefits for services not covered by Medicare

Good basic dental
benefits;
Routine dental care Not covered Not covered Not covered
supplement for
$29 a month

$0 co-pays for eye $0 co-pays for eye
Routine vision care Not covered Not covered exam, exam,
contacts/glasses contacts/glasses
$0 co-pays for
Hearing benefits Not covered Not covered hearing exam & Limited benefits
evaluation

After $250 After $250
Foreign travel deductible, 80% of deductible, 80% of Some coverage Some coverage
emergencies costs ($50,000 costs ($50,000
lifetime limit) lifetime limit)

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