Page 2 - Cover Letter and Evaluation for Mr. Fred Falten

of the Advantage plans compared in your evaluation, call its toll-free number (shown
on page 4 of the evaluation).

Your physicians’ network affiliations

All your doctors accept Medicare-approved rates, as shown in Appendix A1. Your questionnaire
indicates that Dr. Bruce Bartolini is your ophthalmologist, but according to Medicare’s provider
directory he is a gastroenterologist. There is a Dr. Claudia Bartolini, who’s an ophthalmologist in
Portsmouth. Both these doctors are listed in Appendix A1.

Appendix A2 indicates that all your physicians are in the network of the Martin’s Point
Advantage plan that’s compared in your evaluation. And Appendix A3 indicates that all but Dr.
Dietz are in the Humana Choice PPO plan network. The provider directories are not always
current, and before enrolling in an Advantage plan you should verify with your doctors’ offices
that they are still in the plan’s network.

Medigap open enrollment

During the first six months you have Part B, you can get a Medigap policy without having to
answer questions about your health. This six-month open enrollment period may be your only
opportunity to get a Medigap policy without having to disclose any pre-existing conditions.

There are a few other instances where you might have a guaranteed right to get a Medigap
policy, but they are not likely to apply in your case unless you move out of the area. Also,
people in reasonably good health may be able to get a Medigap policy without having a
guaranteed right, but they will pay higher premiums. Either way, by not taking advantage of the
Medigap open enrollment period you give up something that could have considerable value.

Dropping Part B

We discussed whether it makes sense for you and your wife to drop your Part B coverage and
then re-enroll in Part B when you retire. It’s fairly common for people to drop Part B – usually
because after retiring they decide to go back to work for a company with 20 or more employees
that offers good health insurance.

In theory, whether you are enrolled in Part B should not affect your underlying Social Security
benefits. By law, all Medicare beneficiaries who receive monthly Social Security payments have
their Part B premiums deducted from those payments (others are billed quarterly). There’s no
guarantee, of course, that there wouldn’t be an error on the part of Social Security if you drop
Part B and later re-enroll, but it seems unlikely.

A possible safeguard is to get the assurance of a Social Security representative that your
benefits will not be affected by dropping Part B. And if a problem were to arise when you re-
enrolled in Part B, you could cite the conversation or memo from the Social Security

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