Page 12 - Cover Letter and Evaluation for Kirk Schmidt

Plans that appear to meet your criteria

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

Plan Name Medigap Plan F Medigap Plan G Medigap Plan N Medigap Plan L

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

Can you continue to see
your physician(s)? Yes Yes Yes Yes

How large is the plan's You can see any You can see any You can see any You can see any
provider who
provider who
provider who
provider who
provider network? accepts Medicare accepts Medicare accepts Medicare accepts Medicare
Do you need referrals to
see specialists? No No No No

25% of the Part A
What is the potential cost No cost for No cost for No cost for deductible of
of a hospital stay? Medicare-covered Medicare-covered Medicare-covered $1,316 (you pay
hospital services hospital services hospital services
$329)

Excellent. It does Excellent. It does Excellent. It does Very good. $2,560
How good is the plan's not have an out-of- not have an out-of- not have an out-of- out-of-pocket limit
catastrophic coverage? pocket limit, pocket limit, pocket limit, for services the
though though though plan covers

What are Medicare's Medigap policies Medigap policies Medigap policies Medigap policies
ratings for this plan? are not rated by are not rated by are not rated by are not rated by
Medicare Medicare Medicare Medicare

Benefits for services not covered by Medicare

Routine dental care Not covered Not covered Not covered Not covered

Routine vision care Not covered Not covered Not covered Not covered

After $250 After $250 After $250
deductible, 80% of deductible, 80% of deductible, 80% of
Foreign travel emergencies Not covered
costs ($50,000 costs ($50,000 costs ($50,000
lifetime limit) lifetime limit) lifetime limit)

2