Page 5 - Cover Letter and Evaluation for Sarah Spero

Both Advantage plans that are compared in your evaluation have zero premiums and zero
deductibles for medical and Rx drug benefits and some coverage for medical emergencies while
traveling outside the country. Here are brief descriptions of these plans, whose benefit
summaries are in the appendices.

• The Blue Shield 65 Plus HMO Plan. This plan has a Medicare quality rating of
four stars and is one of the older Medicare Advantage plans in California.

Co-payments for doctor’s office visits are $15 for primary care and $35 for
specialists. There are some benefits for dental, vision, and hearing coverage,
with two supplemental dental benefit packages also offered for $37.90 and
$11.60 a month, respectively. Before getting the additional dental coverage, it is
a good idea to check with your dentist to make sure that he or she accepts this
coverage.

Other benefits also include a gym membership through Silver Sneakers and a
personal emergency response system. This plan’s benefit summary, including its
costs for your Rx drugs, is in Appendix C2.

• The Scripps Classic Plan offered by SCAN (an HMO). This plan has a Medicare
quality rating of 4.5 out of a possible 5 stars, placing it among the most highly
rated Medicare Advantage plans in the country.

Co-payments for doctors’ office visits are $10 for primary care and $35 for
specialists. Unlike the Blue Shield 65 Plus HMO plan, this plan does not include
dental benefits but it does have limited benefits for routine vision care and
hearing exams, neither of which is covered by Medicare. It has two optional
packages that offer some dental benefits for an additional premium -- $6 a
month or $16 a month, depending on the package you choose.

Other extra benefits provided by this plan are transportation to medical visits
(with an annual limit) and a Silver Sneakers health club membership.
This plan’s benefit summary, including its costs for your Rx drugs, is in Appendix
C3.

Rx Drug Plan Coverage

Please verify that the drugs, dosages, and monthly quantities that I entered in Medicare’s Plan
Finder program are accurate – these are shown on the first page of Appendix D1. This is the list
was used by Medicare’s Plan Finder program to estimate your Rx drug costs in each plan.

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