Page 10 - Cover Letter and evaluation for Michael Hartzmark

Plans that appear to meet your criteria

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

Plan Name Medigap Plan G Medigap Plan N Medigap Plan L

Toll-Free Number NA NA NA
QuaSection Heading How do these plans compare?
lity ratings from

Can you continue to see

your physician(s)? Yes, but verify Yes, but verify Yes, but verify

How large is the plan's You can see any provider You can see any provider You can see any provider
provider network? who accepts Medicare who accepts Medicare who accepts Medicare

Do you need referrals to
see specialists? No No No

Range of premiums
(according to CSG $2,760 - $3,943 $2,041 - $3,168 $2,098 - $3,211

Actuarial)

How many insurance
companies sell this plan in 26 23 5
your state?

How good is the plan's Excellent, but it does not Excellent, but it does not $3,110 out-of-pocket limit
catastrophic coverage for have an out-of-pocket have an out-of-pocket for covered services in

medical costs? limit limit 2021
Benefits for services not covered by Medicare

Routine dental care Not covered in most cases. Not covered in most cases. Not covered in most cases.
A few insurers may offer A few insurers may offer A few insurers may offer
dental/vision benefits with dental/vision benefits with dental/vision benefits with
Routine vision care their Medigap policies their Medigap policies their Medigap policies

80% of cost of medical 80% of cost of medical
Foreign travel emergency; $250 emergency; $250
emergencies deductible; $50k lifetime deductible; $50k lifetime Not covered
limit limit

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