Page 11 - Evaluation for Jerri Zerlaut
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Plans that appear to meet your criteria (cont'd)
Plan name Medigap Plan F Medigap Plan G Medigap Plan N Medigap Plan L
Toll-Free Number NA NA NA NA
Estimated annual premiums for medical coverage
lity ratings from Medicare web site (best rating = 5 stars)
2017 standard Part B
premium of $134 a $1,608 $1,608 $1,608 $1,608
month*
Health plan annual
premiums (Medigap premiums $1,725 $1,525 $1,250 $1,125
are estimates)
Total $3,333 $3,133 $2,858 $2,733
Minimum costs for Medicare-covered services
Total medical premiums $3,333 $3,133 $2,858 $2,733
(from above)
Plan health deductible
(includes Part B deductible if not $0 $183 $183 $183
covered by plan**)
Annual Rx costs (mail-order,
includes premiums, deductibles, co- $1,162 $1,162 $1,162 $1,162
pays)
Total Minimum Costs
(includes cost-sharing for the Rx $4,495 $4,478 $4,203 $4,078
drugs you now take)
Cost-sharing for doctors office visits
=
In-Network Primary
Care Co-Pays up to $20 for
No co-pays for
No co-pays for
In-Network Specialist Medicare-covered Medicare-covered Medicare-approved 5% of Medicare-
doctor's visit; $50
Co-Pays services services for emergency approved cost
Out-of-Network room visit
Co-Pays
*This is 2017 Part B premium for new enrollees who are not yet receiving Social Security benefits. People who
have already started their Social Security benefits will pay $109 a month ($1,308 a year). Higher income people
may pay more. **Part B deductible is $183.
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