Page 2 - Cover Letter and Medicare Evaluation for Heidi Bathon

AARP MedicareRx Preferred Prescription Drug Plan, and you can enroll in this plan
by calling (888) 877-5564.

How do Medigap policies work?

Perhaps the most desirable attribute of Medigap policies is the flexibility they offer. There are
no networks, and you do not need referrals to see specialists. You will be covered when you see
any provider who accepts Medicare (as more than 99% of doctors and public hospitals do).

When you have a Medigap policy and go to a doctor or other medical provider, he or she will
send the bill for your visit to Medicare. Then Medicare pays the doctor what it owes – usually
80% -- and forwards the 20% balance to the Medigap insurance company that issued your
policy. After the Medigap insurer pays the doctor some or all of the 20% balance, the doctor
will then send you a bill for any remaining amount that was not paid either by Medicare or the
Medigap insurance company.

One nice feature of this kind of coverage is that Medicare makes the coverage decisions, and
not an insurance company. When Medicare pays for a medical service or treatment, the
Medigap insurer is also required to pay. That’s different from an Advantage plan, where the
insurance company can in some cases decide whether a service will be covered.

Unlike most Medicare Advantage plans, Medigap policies do not cover routine dental and vision
care or hearing aids. That’s because Medicare doesn’t currently cover these treatments,
although it does cover diseases of the eye (glaucoma, cataracts, etc.). There are, here and
there, a few “innovative benefit” Medigap plans that offer limited dental/vision benefits,
although before relying on these you should verify with your dentist and optometrist that they
will accept this coverage.

Comparing the three Medigap plans

The Medigap plans compared in your evaluation – Plans F, G and N – are similar, and they are
the three most popular plans. The benefit designs of all 10 Medigap plans are shown on pages
6-7 of your evaluation. Here are the brief summaries of the three that are compared in your
evaluation:

1) Medigap Plan F. This is the most comprehensive Medigap plan, and it covers all of
Medicare’s gaps. You can likely purchase Plan F for $3,100 a year or perhaps less
(roughly $260 a month). Many people choose Plan F for the convenience of never
having a co-payment for a Medicare-covered service. Premiums are in Appendix B1

2) Medigap Plan G. This plan is identical to Plan F except that it does not cover the annual
Part B deductible, which is $203 in 2021. So, this year if you could get Plan G for at least
$204 less per year than you’d pay for Plan F, you’d come out ahead. You should be able
to get Plan G for roughly $2,800 a year. Premiums are in Appendix B2.

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