Page 4 - Cover Letter and Medicare Evaluation for Jamie Marshall

Someone whose physician has recommended a joint replacement in the next year or so can
switch to a Medigap policy for a year and then after the replacement surgery can switch back to
an Advantage plan during the next open enrollment.

1) Medigap Plan G. This is the most comprehensive Medigap plan available to people who
turned 65 in 2020 or later. It covers all of Medicare’s gaps except for the annual Part B
deductible, which is $233 this year. After you’ve paid the Part B deductible, then, you
will not have any cost-sharing for Medicare-covered services. Estimated annual
premiums are $3,200, but you may be able to get a policy for less than that.

2) Medigap Plan N. While this plan is slightly less comprehensive than Plan G, it still
provides solid coverage. The only differences between this plan and Plan G are that you
will have co-payments of up to $20 for doctors’ office visits and $50 if you go to the
emergency room. You should be able to get Plan N for about $2,600 a year or perhaps
slightly less. Unless you go to your doctors frequently, you will likely come out ahead in
this plan vs. Plan G, although you will have several small co-payments. You could start
with Plan N, though, and later upgrade to Plan G if you wish.

3) Medigap Plan L. While this plan is not as popular as the two Medigap plans above, it
does have an out-of-pocket limit of $3,310 for covered services, not including
premiums. The only Medicare service it does not cover is the up-to-15% excess charge
mentioned earlier. Even though this plan has solid coverage and the security of an out-
of-pocket limit, it is not heavily marketed, and the lack of competition keeps premiums
higher than they should be. You can get this plan for about $2,600 a year, or roughly the
same as Plan N.

Pricing Medigap policies

Premiums for the three Medigap plans compared in your evaluation are in Appendices B1
though B3. Each of these appendices includes two sets of quotes – the first is from the State of
New York’s Department of Financial Services (DFS) and the other is from CSG Actuarial, a
quoting service for insurance agents. Since the coverage for a given plan is identical regardless
of the company, you should go with a company that has low premiums.

As you can see, in some cases the quotes from the same insurance company are different in the
DFS listings and the CSG Actuarial listings. One reason could be that a few of the quotes from
CSG Actuarial may not include commissions (I don’t know which ones, though), and it’s also
possible that some quotes are out of date. Another consideration is that some companies may
schedule their annual increases during the first quarter, so that by the time your policy goes
into effect on April 1, premiums will be higher than those shown.

To get accurate current quotes, you will need to call two or three companies (their phone
numbers are in Appendix B4). Then you can choose the company that has the lowest premiums.
If premiums are similar for two companies, you might choose the company with the higher S&P

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