Page 2 - Diane Peasley's Medicare Evaluation

Perhaps the most desirable attribute of Medigap policies is the flexibility they offer. You do not
need referrals to see specialists and you will be covered when you see any provider who
accepts Medicare (as some 99% of doctors and public hospitals do). That means you can see
virtually any doctor in the U.S. or go to any hospital or clinic and be covered. Because Medigap
policies are nationally standardized, your benefits and coverage are the same in every state.
Probably the least desirable feature of Medigap policies is that they are expensive.

Medigap policies do not include prescription drug benefits, and if you choose to buy a Medigap
policy, you will also need to enroll in a Part D stand-alone drug plan, as discussed in the Rx drug
coverage section below. Also, Medigap policies do not cover routine dental and vision care or
hearing aids. Plan F includes some benefits for medical emergencies while traveling outside the
United States (as shown on pages 6-7).

Here are summaries of the two Medigap plans compared in your evaluation, listed in the order
of their comprehensiveness.

1) Medigap Plan F. This is the most comprehensive any Medigap plan, covering all of
Medicare’s gaps. That means that if you get Plan F, you will have no cost-sharing for
Medicare-covered services. Beginning in 2020, Plan F will no longer be sold, although
people who already own this plan at that time may keep it. You can likely purchase a
Plan F policy for about $220 a month or less.

2) Medicare Plan L. This is a less comprehensive Medigap plan but it still provides good
coverage. One desirable feature of this plan is its low $2,480 out-of-pocket limit – it is
one of only two Medigap plans that has an OOP limit. But the limit does not include
premiums and applies only to the services the plan covers. As an example, the Part B
deductible ($183 in 2017) is not covered by this plan and so any money you spend
toward the deductible does not count toward the out-of-pocket limit. Annual premiums
for Plan L are about $1,700.

There are also other Medigap plans that have solid coverage, and you might want to consider
one of those. Plan G and Plan N are slightly less comprehensive than Plan F and can be good
choices, depending on their premiums. Plan G is identical to Plan F except it does not cover the
Part B deductible ($183 in 2017).

Before choosing an insurance company to buy a Medigap policy from, it’s a good idea to get at
least three quotes and to choose a large company that has low premiums. Appendix B lists the
most recent premiums of all the Medigap insurers as well as their toll-free numbers.

Three of your doctors accept Medicare assignment

In deciding which Medigap plan you might want, one factor to consider is whether your doctors
accept Medicare assignment. Providers who accept assignment have agreed to accept
Medicare-approved rates. And if they do not accept assignment, they can charge up to 15%

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