Page 11 - SAMPLE

Plans that appear to meet your criteria

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

AARP Medicare
Blue Medicare
Plan Name Medigap Plan F Medigap Plan L Complete Choice
Lifetime HMO
Plan Two
Toll-Free Number NA NA (855) 601-9465 (800) 555-5757
QuaSection Heading How do these plans compare?
lity ratings from
Yes, but Yes, but Yes, but
Can you continue to see chiropractic chiropractic Dr. Duncan chiropractic
your physician(s)? services may not services may not (chiropractor) not services may not
be covered be covered covered be covered

How large is the plan's You can see any You can see any 18,000 - 19,000
provider who
provider who
provider network? accepts Medicare accepts Medicare 2,500 - 3,000 providers

Do you need referrals to Yes (except in
see specialists? No No emergencies) No

25% of the Part A
What is the potential cost No cost for deductible of $225 a day for days $395 a day for days
of a hospital stay? Medicare-covered $1,316 (you pay 1-7; nothing 1-4; nothing
hospital services thereafter thereafter
$329)

Excellent. It does Very good. $2,560 Below average:
How good is the plan's not have an out-of- out-of-pocket limit Below average: $6,700 in network;
catastrophic coverage? pocket limit, for services the $6,500. Network $10,000 in and out
services only
though plan covers of network

What are Medicare's Medigap policies Medigap policies
ratings for this plan? are not rated by are not rated by 3.5 stars 4 stars
Medicare
Medicare
Benefits for services not covered by Medicare

Routine dental care Not covered Not covered Not covered Not covered

Routine vision care Not covered Not covered Not covered Limited benefits

After $250
deductible, 80% of
Foreign travel emergencies Not covered Not covered Not covered
costs ($50,000
lifetime limit)

2