Page 2 - Cover Letter and Evaluation for Patricia Stelter -- PDF version

 If you decide to get a Medigap policy and a Part D stand-alone plan, you should
first decide which Medigap plan you want – Medigap Plan G or Medigap Plan N
or another plan. Then it’s a good idea to call three or more insurers and get
current quotes before deciding which company you’ll get your policy from.

 And if you get a Medigap policy, you’ll also need to enroll in the Part D stand-
alone plan that has the lowest costs for your Rx drugs. You can call the plan’s
toll-free number, which is shown on page 4 of the evaluation. As explained in the
Rx drug coverage section later, next year’s lowest-cost plan – the SilverScript
Smart Rx Plan – begins its coverage in January, and so you will need to choose
another plan for the month of December (see below).

Making sure your doctors accept the plan you enroll in

Based on the information shown in Appendix A, it seems likely that your physicians will accept
any of the coverage options that are compared in your evaluation. Once you’ve decided on the
plan you will enroll in, we suggest that before you enroll you confirm with your doctors’ office
that they will accept this coverage.

If you get a Medigap policy, your doctors need to accept Medicare (also called original
Medicare or traditional Medicare). While almost all providers do accept Medicare, there are a
very few who will accept Medicare Advantage plans but not accept original Medicare. In
Appendix A both the CR Medical Group (listed as the Candr Medical Group) and Dr. Manjunath
are listed as accepting Medicare.

I was unable to find the CR Medical Group in the Advantage plan provider directories, but Dr.
Corinne Nawrocki of this group is listed. Although she may not be your doctor, it’s likely that if
she accepts Medicare then the CR Medical Group does also – but again, you should confirm this
before enrolling in either of these Advantage plans.

The two Medigap plans in your evaluation

Two of the four options compared in your evaluation are Medigap policies – Medigap Plan G
and Medigap Plan N. It might be helpful to review certain features that all Medigap policies
share (you may already be aware of these). Perhaps the most desirable of these is the flexibility
they offer. There are no networks, and you are covered when you see any provider who accepts
Medicare (as some 99% of doctors and public hospitals do). With a Medigap policy, you can go
to virtually any doctor, public hospital or clinic in the United States and be covered.

Another strength of Medigap policies is that Medicare, not the insurance company, makes the
coverage decisions. And if Medicare approves a service or treatment, the Medigap insurer must
also cover it, up to policy limits. Because Medicare is more lenient in approving certain
treatments than are insurance companies, Medigap policyholders may in some cases be
covered for treatments that people in Advantage plans may not be (the Advantage plan could

2