Page 4 - Cover Letter and Evaluation for Patricia Stelter -- PDF version

covered services for the remainder of the year. Premiums vary widely (as you can see in
the appendices). For Plan G, you should be able to get a policy for about $1,600 a year
or slightly less.

2) Medigap Plan N. This plan is less comprehensive than Plan G but is still very good
coverage. Its gaps include the $198 Part B deductible, co-pays of up to $20 for doctor’s
office visits, and a $50 co-pay for emergency room visits. Annual premiums are roughly
20% lower than Plan G’s, and if you do not go to the doctor frequently you would
probably save money in this plan compared to what you would pay in Plan G. You can
likely get Plan N for about $1,200 a year or less.

Medigap Pricing and Discounts

Companies that sell Medigap policies often offer discounts. As an example, some companies
offer small discounts for automatic debit payments or for paying a year’s premiums in advance.

The largest discounts are the “household discounts” offered by some insurers when both
spouses sign up for Medigap policies. These discounts usually range between 3% and 10%. The
premiums from CSG Actuarial in Appendices B2 and B3 show the percentage amounts of these
discounts for the companies that offer them, and the premiums that are listed include these
discounts. Besides the discounts, some Medigap insurers include what are known as
“innovative” benefits like a Silver Sneakers membership and limited dental coverage.

Another thing to keep in mind is that in Illinois, the UnitedHealthcare/AARP policies offer an
early enrollment discount that equals 3% a year for each year someone is younger than 77. In
your case, this discount would be 36%. The only thing to be aware of with the early enrollment
discount is that you will likely have two premium increases each year – the first a 3% increase
as the discount gradually vanishes and the other an increase for health care inflation.

With an AARP policy, then, your premiums may go up more quickly until you turn 77. After that,
they may increase more slowly than those of many other insurers because the AARP premiums
are based on a modified community rating that tends to favor older retirees.

The two Medicare Advantage plans in your evaluation

Medicare Advantage plans are managed-care plans – HMO’s and PPO’s, for the most part. In
Will County there are 49 Advantage plans, although a few of these plans do not include Rx drug
coverage. Because you do not have creditable drug coverage from another source, you cannot
enroll in an Advantage plan that doesn’t include drug coverage.

In Appendix C1, the plans are ranked by their monthly premiums. Although I was unable to find
both your providers in the network directories of some plans, I did find them in the two plans
that are compared (again, you should verify that they will accept this plan before enroll). Both
plans have above-average four-star quality ratings from Medicare, and their benefit designs are

4