Page 6 - Cover Letter and Evaluation for Sarah Spero

The costs shown by Plan Finder assume you will be enrolling on the first day of the coming
month (August 1). Your costs will be less than those shown in the printouts because your
enrollment will not begin until October 1.

Both your eye medications are dispensed in 5ml bottles, and there are approximately 100 drops
in each bottle. You indicated that you use one drop of fluorometholone in each eye two times a
week, or four drops a week – so one 5ml bottle should last about 25 weeks. With the Medicare
Plan Finder, the longest interval available (other than a full year) is three months, and that is
the refill frequency that I chose for this drug. For tobramycin, which you use as needed, I chose
a refill frequency of every two months.

These are estimates, of course, and you will pay only for the prescriptions that you fill. The
good news is that your drug costs are low (all your drugs are generics). That is particularly true
for the two Advantage plans, as shown on page 4 of your evaluation.

You can often save money by using one of a plan’s preferred pharmacies, where you will have
the lowest co-payments. As an example, if you decide to enroll in the Blue Shield 65 Plus HMO
Plan, you will save money by getting your prescriptions filled at a CVS pharmacy instead of Rite
Aid. In this plan you will pay $15 for your drugs during the last three months of the year
(assuming you go to a CVS Pharmacy). These costs are detailed in Appendix C2.

If you enroll in the Scripps Classic Plan, you will pay a total of $45 for the last three months of
this year, and you can continue to go to Rite Aid for your prescriptions. Also, in this plan if you
switch to mail-order refills, you will pay nothing for your prescriptions for the last three months
of 2020, as shown in Appendix C3. If you do switch to mail-order, you will need to ask your
physicians for new prescriptions.

Finally, if you get a Medigap policy, you will pay $146 in the lowest-cost stand-alone drug plan –
the Anthem Blue Cross MediBlue Rx Enhanced plan. That amount includes premiums and co-
payments, and it assumes you will get your prescriptions filled at a CVS pharmacy. To enroll in
this plan, you would call (800) 261-8667. This plan’s benefit summary is in Appendix D2.

Summary

As you can see from the costs shown on pages 2-4 of your evaluation, your fixed costs
(premiums + deductibles) are much higher with Medigap policies + stand-alone drug plans than
they are with the Advantage plans. Both Advantage plans in your evaluation have zero
premiums and zero deductibles for health and Rx drug coverage.

In a worst-case, your costs could be slightly higher with the Advantage plans – one has a $3,400
out-of-pocket limit for medical services and the other a $3,399 limit. These limits do not include
your prescription drug costs, which are substantially less expensive in the Advantage plans than
in the stand-alone drug plan.

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