Page 2 - Cover Letter and evaluation for Michael Hartzmark

issued, and where you are registered to vote. And I mentioned that you will have higher
Medigap premiums in Florida. For Medigap Plan G, for instance, your annual premiums in
Florida will be roughly $700-$800 more than in Chicago.

Given the above residency criteria, if you have the option of getting your Medigap policy in
Illinois you may be able to save some money, at least in the short term. Each insurance
company has its own guidelines about how to adjust premiums for dual-state residency, and
you might want to clarify its policy with the insurance company you get your policy from. Your
evaluation assumes a Florida residency, but in case you want to compare Medigap premiums in
the Chicago area, you can access them at this link:
https://www2.illinois.gov/aging/ship/Documents/ChicagoMedSupWeb.pdf

There are two reasons for the large differences in the two states’ Medigap premiums: 1) Florida
requires Medigap insurers to use the “issue-age” ratings approach in setting premiums. This
results in higher initial premiums but lower annual premium increases (states that have large
retiree populations often require companies to use “issue age” ratings); 2) healthcare costs in
South Florida are among the highest in the nation, which translates to high Medigap premiums.

Dr. Ewert accepts Medicare-approved rates

As shown in Appendix A, Dr. Ewert accepts Medicare-approved rates. Because he is a Medicare
provider, when he refers you to other providers for lab tests, x-rays, physical therapy, etc.,
those services will be covered by Medicare (assuming they are services that Medicare covers).

Medicare providers such as Dr. Ewert can charge annual concierge fees, so long as the fees are
for services that Medicare doesn’t cover. Typically, a primary care physician with a concierge
practice will offer extra benefits like same-day appointments, week-end availability for
telephone consultations, etc. Concierge fees make it possible for primary care physicians to
reduce the number of patients they see, so that each patient gets additional attention, longer
office visits, and so on.

The three Medigap plans compared in your evaluation

Your evaluation compares Medigap Plans G, N, and L. You can see the benefit designs of these
three plans and other Medigap plans on pages 6-7 of your evaluation.

It might help to review some features that all Medigap policies share (you may already be
aware of these). Their strongest point is the flexibility they provide when you choose providers.
There are no networks, and with a Medigap policy you will be covered when you see any
provider who accepts Medicare (as some 99% of doctors and public hospitals do). Thus, you can
go to virtually any doctor, public hospital or clinic in the United States and you’ll be covered.

Another strength of Medigap policies is that Medicare, not the insurance company, makes the
coverage decisions. And if Medicare approves a service or treatment, the Medigap insurer must

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