Page 1 - Rx Drug Evaluation for Mrs. Irene Ellsworth

November 15, 2018

TO: Mrs. Irene Ellsworth

Dear Mrs. Ellsworth,

The attached spreadsheet shows the estimated 2019 costs for your drugs in different Part D
stand-alone plans. The costs that are shown are total costs -- premiums, deductibles, and co-
payments -- for the seven drugs you are taking.

Please verify that the list of your drugs, their dosages and monthly quantities in Appendix A is
accurate – this list was used on the Medicare Plan Finder to identify the lowest-cost plans.

You can save a substantial amount if you switch from your current Humana Walmart Rx Plan to
the Express Scripts Medicare Saver prescription drug plan and get your refills at a CVS pharmacy
instead of Safeway. You could also gain some added savings by switching to mail-order refills, at
least for those drugs you anticipate taking for more than six months. Details are shown on the
following page and in the appendices. As you know, you will need to make this change prior to
December 7, when Medicare’s annual fall open enrollment period ends.

To switch to the Express Scripts Medicare Saver plan, you can call the plan’s enrollment number
at (866) 477-5704 and let the representative know you want to enroll effective January 1, 2019.
There are several Express Scripts prescription drug plans, and so make sure the representative
enrolls you in the Express Scripts Medicare Saver plan.

You do not need to dis-enroll from your current Humana-Walmart Rx Plan – when Medicare is
notified that you have enrolled in a different plan, it will dis-enroll you from the Humana-
Walmart plan at the end of the year.

In the Express Scripts Medicare Saver plan, if you are willing to get your prescriptions filled at a
CVS Pharmacy you can save almost $400 compared to getting them filled at Safeway. You
should not need new prescriptions from your doctors because your prescriptions can probably
be transferred to your new plan. Both CVS and Safeway are in the pharmacy networks of your
current plan and your new plan.

For the two drugs that you will take three times weekly for six months – dexamethasone and
ondansetron – I estimated an annual quantity of 78 tablets for each drug (three tablets a week
x 26 weeks). To estimate your annual costs, I spread those 78 tablets over the full year (13
tablets every two months). This was just to get a cost estimate, and your physician will
prescribe these two drugs in different quantities over shorter time periods.