| POLICY 1 | POLICY 2 | POLICY 3 |
| Does the policy cover: | YES NO | YES NO | YES NO |
| Medicare Part A hospital deductible? |
| Medicare Part A hospital daily coinsurance? |
| Hospital care beyond Medicare's 150-day limit? |
| Skilled nursing facility (SNF) daily coinsurance? |
| SNF care beyond Medicare's limits? |
| Medicare Part B annual deductible? |
| Medicare Part B coinsurance? |
| Physician and supplier charges in excess of Medicare's approved amounts? |
| Medicare blood deductibles? |
| Prescription drugs? |
| Other Policy Considerations |
| Can the company cancel or non-renew the policy? |
| What are the policy limits for covered services? |
| How much is the annual premium? |
| How often can the company raise the premium? |
| How long before existing health problems are covered? |
| Does the policy have a waiting period before any benefits will be paid? How long? |
| Most states now require that these benefits be included in all newly issued Medigap policies. |
| NOTES |
