Page 18 - Cover Letter and Mediicae Evaluation for Mr. Bruno V. Manno
P. 18

Medigap policies -- an overview


                                  Frequently asked questions about Medigap policies

          What is a Medigap policy?                                   What are the most popular plans?
          It's a standardized supplemental insurance           Plan F accounts for 40% of Medigap policies
          policy that fills some of the gaps in Medicare       sold, followed by Plan C at 13%. Of the four
          coverage. There are 10 plans (see pp. 6-7).           comprehensive plans that have higher cost
          Medigap policies don't have network                       sharing, Plan N is the most widely sold.
          restrictions, so policyholders can see any
          doctor who accepts Medicare. Also,                        Are premiums based on my health?
          Medicare makes the coverage decisions, not          When you buy a policy during your initial six-
          the insurance company.                            month open enrollment period, you cannot be
                                                             denied coverage or charged more because of
          Which plans have the best coverage?                                       pre-existing conditions.
          Plans C, D, F and G all have solid                       What are the open enrollment rules?
          comprehensive coverage. Because of a                    Even though you will not be asked health

          recent change in the law, Plans C and F            questions during your initial open enrollment
          cannot be sold to people who turn 65 in                  period, insurance companies may adjust
          2020 or later. For these individuals, Plan G is        premiums based on your age, gender, and
          the most comprehensive plan available,           smoking status. After the initial six-month open
          covering all Medicare's gaps except for the         enrollment period is past, in most states you
          Part B deductible. Those who turned 65           will have to answer health questions before you
          before 2020 can still get Plan C or Plan F.                             can get a premium quote.

          People in good health might also consider              Can I switch insurers and plans later?
          one of the Medigap plans with higher cost-           Yes, in some cases. A handful of states have
          sharing -- Plans K, L, M, and N. Medicare            laws that allow you to switch your Medigap
          covers 100% of the cost of preventive              policy to another insurance company without
          services, which reduces your risk with these       disclosing pre-existing conditions. But in most

          plans. In particular, Plan N is likely to save   states, you will have to answer questions about
          money for those in good health.                    your health before you receive a quote. And if
          Which plans have the most risk?                  you have health problems, you could be denied
          Plans A and B both have coverage gaps of           coverage and would have to remain with your
          almost $13,000 for skilled nursing facility                current insurer. In a limited number of

          care. For that reason, they are riskier than     situations, you have a guaranteed right to get a
          other Medigap plans. Plan K also has fairly       policy without answering health questions.  As
          sizable risk, but unlike Plans A and B, it has    one example, Advantage plan enrollees have a
          an out-of-pocket limit that offers some                  guaranteed right to get certain Medigap
          protection. Only two Medigap plans -- Plan K      policies if they move out of their plan's service
          and Plan L -- have out-of-pocket limits.                                                  territory.



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