Page 2 - Cover Letter and Evaluation for Gary Janke

have Part A and Part B without having to answer health-related questions. Insurance
companies, can, however, adjust your premiums for age, gender, and smoking status.

After that six-month period guaranteed-issue period is past, you will likely have to answer
questions about your health before you can get a Medigap policy or, if you already have one,
before you can upgrade to a more comprehensive Medigap plan or switch insurance
companies.

Perhaps the most desirable attribute of Medigap policies is the flexibility they offer. You do not
need referrals to see specialists and will be covered when you see any provider who accepts
Medicare (as more than 99% of doctors and public hospitals do). Because Medigap policies are
standardized, the benefits remain the same every year – only the premiums and in some cases
the co-payments go up.

Medigap policies do not include prescription drug coverage, and so you will need to enroll in a
Part D stand-alone drug plan. Neither do Medigap policies cover routine dental and vision care
or hearing aids. Both Medigap plans in your evaluation include some benefits for medical
emergencies while traveling outside the United States. Benefit designs for all 10 Medigap plans
are shown on pages 6-7. Here are summaries of the two plans in your evaluation.

1) Medigap Plan G. This plan has comprehensive benefits, and the only Medicare gap that
it does not cover is the Part B deductible, which is $183 in 2018. That means that almost
your entire cost for Medicare-covered services will be your premiums. In middle
Tennessee you can probably get a Plan G policy for $1,500 a year or perhaps less.

2) Medigap Plan N. This is a slightly less comprehensive plan than Plan G but still provides
excellent coverage. Annual premiums for Plan N for someone your age are about
$1,275, although you may be able to purchase a policy for less.

Medicare-approved rates

Dr. Ryan accepts Medicare-approved rates, as shown in Appendix A.

The pricing of Medigap policies

If you decide to get a Medigap policy, it’s good to give some thought as to the company that
you will buy your policy from as well as to make a few calls to get current quotes. While it’s
important to go with a company that has relatively low premiums, you may also want to factor
in a company’s financial strength and size. As a rule, larger companies have slightly lower
annual premium increases, according to a government study a few years ago.

The premium comparisons in Appendix B1 and B2 are from CSG Actuarial, a firm that provides
quotes for insurance agents. Some premiums in the CSG lists may be lower than you can get
because the commissions may not be included (unfortunately, there’s no way to filter these out

2