Page 6 - Cover Letter and Medicare evaluation for Dr. Peter Yesawich

coverage. That’s not an option, though, for stand-alone drug plans, which make their profits
solely on drug coverage.

That said, there’s a huge difference of roughly a $2,300 a year in Rx drug costs between the
Bright Advantage plan and the lowest-cost Part D stand-alone plan. This large gap is particularly
surprising since all your drugs are generics. If you like, I will re-run your costs in a couple of
weeks, in case there might be an error in Medicare’s Plan Finder program (which happens
occasionally). Also, you can check the costs for each of your drugs under the various options in
the plans’ summaries in the appendices. You’ll see that the costs for a drug may vary
substantially from one plan to the next.

A list of your lowest-cost stand-alone drug plans is in Appendix C1. This list is ranked by the
plans’ estimated annual costs for your drugs, with the SilverScript SmartRx plan being the
lowest-cost plan. It has an estimated $2,761 annual cost if you get monthly refills at a CVS
pharmacy and $2,647 if you switch to mail order. These numbers include premiums and co-
payments. The next lowest-cost stand-alone plan costs an estimated $4,166 for your drugs in
2021. The SilverScript SmartRx plan’s summary is in Appendix C2.

In contrast, the Bright Advantage Part B Savings PPO Plan has an estimated annual cost of only
$438 if you get your prescriptions filled at a CVS pharmacy. And if you get your prescriptions
filled at a Walmart pharmacy, your estimated annual costs drop to $333, shown in Appendix C2.

In the Aetna Medicare Premier Plus PPO plan, your estimated annual costs are $1.483 at a CVS
pharmacy and $1,352 for mail-order.

Ways you might trim your Rx costs

If you get a Medigap policy and a stand-alone drug plan, there are two ways that you might be
able to reduce your drug costs. The first way is to purchase some of your drugs without
insurance when you find that a drug’s retail price is lower than your co-payment (if you ask for
a drug’s retail price without insurance, pharmacists are required to tell you). The possible
downside of this approach is that as your total drug spending goes through Part D’s different
coverage phases, you could be postponing the point at which you enter a less expensive phase.

The other way is to use your COBRA drug coverage if is less expensive than the SilverScript
SmartRx Plan. As earlier noted, you would do this only if your COBRA drug coverage is
considered to be “creditable drug coverage” by Medicare – something that the plan’s benefit
summary should indicate.

Weighing your options

Your minimum costs with a Medigap policy and stand-alone drug plan are several thousand
dollars more than in either of the Advantage plans in your evaluation. Minimum costs are the
costs you know you will pay even if you don’t go to a doctor. They are the sum of your Part B

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