Page 11 - Cover Letter and Medicare Evaluation for Heidi Bathon
P. 11
Plans that appear to meet your criteria (cont'd)
Medigap Plan Name Medigap Plan F Medigap Plan G Medigap Plan N
Toll-Free Number NA NA NA
Estimated annual premiums for medical coverage
lity ratings from Medicare web site (best rating = 5 stars)
2021 Standard Part B
premium ($148.50 a $1,608 $1,608 $1,608
month)*
Health plan annual
premiums (Medigap $3,100 $2,800 $2,350
premiums are estimates)
Total $4,708 $4,408 $3,958
Minimum costs for Medicare-covered services
Total medical premiums $4,708 $4,408 $3,958
(from above)
Plan health deductible
(includes Part B deductible if $0 $203 $203
not covered by plan**)
Annual Rx costs, mail-
order (premiums, $4,850 $4,850 $4,850
deductibles, co-pays)
Total Minimum Costs
(includes cost-sharing for the $9,558 $9,461 $9,011
Rx drugs you now take)
Cost-sharing for doctors office visits
=
In-Network Primary After the annual Part B
Care Co-Pays deductible of $203 is paid,
No co-pays after the there are up to $20 co-
In-Network Specialist No co-pays for Medicare- annual Part B deductible pays for doctors' office
Co-Pays covered services ($203) is paid visits and a $50 co-pay for
Out-of-Network a visit to the emergency
Co-Pays room.
*This is 2021 standard Part B premium for new enrollees who are not yet receiving Social Security benefits.
**Part B deductible in 2021 is $203.
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