Page 2 - Evaluation for Tom Tappan

network costs, e.g., a PPO plan might have a $5,500 out-of-pocket limit for network services but
a $7,500 out-of-pocket limit for combined network and non-network services.

Your primary care physician

As shown in Attachment A, the Medicare web site indicates that Dr. Hargan accepts Medicare
assignment, which means that he agrees to accept Medicare’s approved payment rates. Some
physicians accept Medicare but not Medicare assignment, in which case they can charge up to
15% more than Medicare-approved rates.

Dr. Hargan is also listed as a network provider in the BofA Advantage PPO plans (also shown in
Attachment A). Another indication that he will accept the BofA plans is that he currently
accepts at least one other Advantage plan. As I read the BofA benefit summaries, you will be
covered when you go to any physician so long as that physician has not opted out of Medicare
(fewer than 1% of doctors do this) and is willing to accept the BofA plan’s payment.

In the unlikely event that Dr. Hargan will not accept the new BofA plan – possibly because the
online directory is out of date -- you might have to pay full cost for his visits. But given the
substantial savings you will realize in lower medical premiums and Rx drug costs, you would still
likely come out far ahead of what you’d pay with a Medigap policy.

One thing to be aware of is that if Dr. Hargan does not accept the BofA Advantage plans, some
PPO plans consider any services, treatments, or tests that he orders to be unauthorized, even if
he refers you to a network specialist for those tests and treatments. Again, this is unlikely to be
an issue. Here are brief descriptions of the options compared in your evaluation:

The Medigap plans in your evaluation

Perhaps Medigap policies’ best feature is that they do not have provider networks. You do not
need referrals to see specialists and you will be covered when you go to any doctor who
accepts Medicare. That’s a slightly broader provision than in the BofA plans, where you will be
covered only when you go to doctors who will accept the plans.

Premiums in your area are shown in the B attachments. The premiums from CSG Actuarial in
Attachments B2 and B3 are likely to be more current than those in Attachment B1, but the
insurance companies’ toll-free numbers are shown only in Attachment B1. As mentioned
earlier, Medigap policies do not cover prescription drugs, nor do they cover routine dental and
vision care or hearing aids (the latter two are covered by your BofA plans).

Medigap benefit summaries

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

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