Page 4 - Cover Letter & Evaluation for Isaac Kapon

Medigap benefit summaries

Here are summaries of the two Medigap plans compared in your evaluation:

1) Medigap Plan F. This is the most comprehensive of any Medigap plan and it covers all of
Medicare’s gaps, i.e., you will have no cost-sharing for Medicare-covered services. And if
you see a doctor who does not accept Medicare assignment, any excess charges levied
by that doctor will also be covered. You can likely buy a Plan F policy for less than $2,000
a year (I’ve assumed $1,950 in your evaluation). This is superior but expensive
coverage. It’s also the most comprehensive coverage for surgeries, etc., and you should
have no co-payments for any Medicare-covered services.

2) Medicare Plan L. This plan is less comprehensive than Plan F but still has very good
benefits. Its estimated annual premiums are in the $1,250 range. Even though you will
have some cost-sharing in this plan, you will likely come out a few hundred dollars
ahead of what you’d pay in Plan F – that’s unless you use numerous medical services or
undergo expensive treatments.

In addition, this plan has a $2,560 out-of-pocket limit in 2017 (it is one of only two
Medigap plans that have OOP limits). But that limit applies only to those services that
the plan covers. As an example, Plan L does not cover the Part B deductible, which is
$183 in 2017, and so any payments you make toward the deductible will not count
toward the OOP limit. This is a a less desirable plan to have if you know you are going to
have surgery in the near future.

If you want to consider a less comprehensive Medigap plan like Plan L, the UnitedHealthcare
(UHC) policies endorsed by AARP will permit you later to upgrade to one of the more
comprehensive plans without answering health questions. Some people choose one of the less
expensive Medigap plans sold by UHC knowing that if they later want to upgrade to a different
plan that’s sold by UHC, they will not have to answer health questions. If that is something you
want to consider, you should verify with UHC that you’ll later be able to switch to a higher-level
plan without answering questions about your health.

Other comprehensive Medigap plans you might consider are Plans G and N. Plan G is identical
to Plan F except that it doesn’t cover the Part B deductible. The benefit designs and estimated
annual premiums for all Medigap plans are shown on pages 6-7 of your evaluation.

The two Medicare Advantage plans in your evaluation

1) Humana Choice PPO Plan (H5216-141). Because there are two Humana Choice PPO
plans in Clark County, I included this plan’s ID number to distinguish it from the other
Humana Choice PPO plan. The Humana plan in your evaluation has zero premiums for
health and drug coverage, and it is designed for people who are in good health and who

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