Page 5 - Cover Letter and Evaluation for Melanie

on the first page of Appendix C1. Because you take three drugs on an as-needed basis and a
fourth drug only during allergy season, these costs are estimates.
Also, you indicated that you get refills of metronidazole topical gel every four months, but the
Medicare web site doesn’t offer four months as an option, so I chose three months. That means
your costs in the evaluation may be somewhat overstated.

Also, the clindamycin prescription comes in two sizes – a 50GM jar and a 25GM jar. The 50GM
jar is the default dosage on the Medicare web site and so I chose that. But if it turns out you use
the 25GM jar every two months (and not the 50GM jar) your annual costs will be substantially
less than those shown – although the lowest-cost plan remains the same in either case.

The lowest-cost plan for the Rx drugs you take is the Express Scripts Medicare – Saver
prescription drug plan. If you were enrolled in this plan for the entire 2018 plan year, your
estimated costs would be $1,547. That includes premiums, deductible, and co-payments. As
mentioned, this estimate is based on the quantities that are shown on the first page of
Appendix C1.

CVS pharmacies are preferred pharmacies in the Express Scripts Medicare – Saver plan, which
means you’ll usually get the lowest prices there. Mail-order refills in this plan are almost $350
more expensive for the year, and so you may want to get your prescriptions filled at a local CVS
Pharmacy (you indicated on your questionnaire that you get monthly refills at CVS and also get
mail-order refills).

The next lowest-cost plan is also sponsored by Express Scripts, but it does not list CVS as a
preferred pharmacy and you would pay much more if you got your refills there. When you
enroll, then, make sure the person you speak with knows that you want the Express Scripts
Medicare – Saver plan. Also, ask whether your prescriptions can be transferred from your
current health plan to the new plan. In some cases prescriptions can be transferred, even when
different insurance companies are involved.

It’s also important to review your Part D plan’s costs each year during annual open enrollment
(October 15-December 7) and to switch plans if you can save a meaningful amount.

What happens to your coverage if you move to another state?

If you move to another state, you can keep your Medigap policy because its coverage is the
same in all 50 states. See Appendix D2 for Medicare’s rule about this.

What about your Part D stand-alone plan if you move? if it is a national plan, you can continue
to use it in your new location. But if it is not a national plan, you may need to change to another
Part D stand-alone plan when you move. Before you move, contact the insurance company that
sponsors your Part D plan to find out if it is a national plan. If it is, you can let the insurer know
you’ll be moving. If it is not a national plan, you have a guaranteed right to enroll in any Part D