Page 2 - Cover Letter and Evaluation for Bob Workman

Therefore, you can go ahead and enroll in the lowest-cost stand-alone plan – the Envision Rx
Plus prescription drug plan. You can do this by calling the plan’s toll-free number, shown on
page 4 of your evaluation and in Appendix D2. You will need to enroll before Medicare’s open
enrollment period concludes on December 7. You do not need to dis-enroll from your current
SilverScript Choice plan – Medicare will do that for you when it learns that you have enrolled in
a different plan. Your new drug coverage will become effective on January 1, 2018.

The other thing you should do prior to December 7 is to decide whether you want to switch
your medical coverage to the Humana Choice PPO plan that’s shown in your evaluation. After
that date you will not be able to change your drug coverage or enroll in a Medicare Advantage
plan until next year.

Washington’s Medigap enrollment rules

The state of Washington’s rules for Medigap enrollment give you more flexibility than do most
other states. In Washington, people who already have a Medigap policy (except for Plan A) can
switch to a different Medigap plan or to a different insurance company at any time of the year
without answering questions about their health (see Appendix B1).

If they do not already have a Medigap policy, though, it could be more difficult for them to get
one. People with serious pre-existing conditions might have to pay higher premiums or might
not be able to get a Medigap policy. Thus the state’s rules provide a great deal of flexibility to
people who already have Medigap policies but not as much to those who are enrolled in
Advantage plans who may want to switch to Medigap policies. Also, if you are in an Advantage
plan, you would likely have to wait until the open enrollment period to change to a Medigap
policy.

Before you switch to an Advantage plan, I’d suggest you talk to one of Washington state’s
Medicare counselors at 800-562-6900 (as shown in Appendix B1). They know the state’s
Medigap rules well and will be aware of exceptions and special circumstances that I am not
aware of. These counselors work for the Washington State Office of the Insurance
Commissioner. They are sometimes referred to as SHIBA counselors (for Statewide Health
Insurance Benefits Advisors), and they are a free government service. You could find out what
future rights you would have to return to a Medigap policy – perhaps several years from now --
after you have been enrolled in a Medicare Advantage plan.

The three Medigap plans in your evaluation

Plan F. This is the most comprehensive of any Medigap plan, covering all of Medicare’s gaps. It
is very good but expensive insurance. In a few cases it can be cost-effective for people who go
to their doctors frequently and use many medical services or undergo expensive treatments.
Because of Washington state’s Medigap rules, you could upgrade to this plan in later years if
you decided it would save you money. Currently its annual premiums are about $1,000 more

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