Page 3 - Cover Letter and Mediicae Evaluation for Mr. Bruno V. Manno

public hospitals do). With a Medigap policy, you can go to virtually any doctor, public hospital
or clinic in the United States and you’ll be covered.

Another strength of Medigap policies is that Medicare, not the insurance company, makes the
coverage decisions. And if Medicare approves a service or treatment, the Medigap insurer must
also cover it. Because Medicare is more lenient in approving certain treatments than are
insurance companies, Medigap policyholders may in some cases be covered for treatments that
people in Advantage plans may not be (an Advantage plan might say that the treatment is not
medically necessary).

Medigap policies do not cover routine vision and dental care or hearing aids (Medicare doesn’t
cover these either). Neither do they cover prescription drugs, and if you get a Medigap policy
you will also need to enroll in a Medicare prescription drug plan (Part D stand-alone plan),
discussed below.

With the exceptions of Plan K and Plan L, Medigap policies do not have out-of-pocket limits,
although that is rarely an issue because Medicare’s underlying catastrophic protection is strong.
Some Medigap plans, including the two of the three compared in your evaluation, include some
coverage for foreign travel medical emergencies.

To get current quotes, you will need to call the insurance companies that sell Medigap policies.
The companies’ phone numbers are listed in Appendix B4, as well as each company’s premiums
(this is a long document, and it’s being sent as a separate attachment).

In addition, premiums for Medigap Plans F, G, and L are in Appendices B1, B2 and B3. These are
from CSG Actuarial, a firm that provides quotes for insurance agents. These premiums are more
current than the ones in Appendix B4, but in some cases they may not include the agents’
commissions (there is no way for me to know which ones these are). In those instances, your
premiums will be higher than those shown.

The CSG Actuarial premiums include the household discounts offered by some Medigap
insurers when both spouses buy a policy. But the premiums from the Maryland Insurance
Administration in Appendix B4 do not.

One way in which CSG Actuarial’s premiums may be helpful is that they rank the companies by
their premiums. This ranking makes it easier find the companies that have lower premiums. The
premiums in Appendix B4 from the Maryland Insurance Administration are not ranked, and so
you need to go company by company to find the lowest premiums.

CSG Actuarial’s premiums also show most companies’ premium increases for the last four
years. In some cases, CSG Actuarial also indicates companies’ financial strength ratings from AM
Best and Standard & Poor’s (S&P). The companies’ phone numbers are not included in CSG
Actuarial’s listings but, as mentioned, are shown in Appendix B4.

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