Page 5 - Cover Letter and Evaluation for Richard Hain

from Medicare. Its less desirable features are an $800 medical deductible and a high
$6,700 out-of-pocket limit for network services. In the cost summaries on page 3, I’ve
assumed that you would spend the entire $800 medical deductible, but in most years
you likely wouldn’t spend that much.

In this plan when you go to an out-of-network provider you will still have some coverage
but will pay 40% of the cost for most office visits and treatments. This plan could be a
good choice for someone who sees several doctors and who wants the flexibility
occasionally to go outside the network, but it is probably not a good choice for you.

Rx Drug Plan Coverage

The UC Health Pharmacy is not listed in Medicare’s directory of pharmacies, but it is probably in
the networks of most Part D plans. Since you use mail-order refills, the choice of a local
pharmacy is less important. But in whatever drug coverage you choose, you might want to
verify whether the UC Health Pharmacy is in the network and if it is a preferred pharmacy in
that network. And when you need a short-term medication, you might check to see if you can
save money by going to one of your plan’s preferred pharmacies, listed on page 4 of the
evaluation.

As noted above, if you purchase a Medigap policy you will also need to enroll in a Part D stand-
alone plan. There are two stand-alone plans in your area whose costs for mail-order refills for
simvastatin are virtually identical – the Express Scripts Medicare Saver prescription drug plan
and the Humana-Walmart Rx Plan. CVS is a preferred pharmacy in the Express Scripts plan and
Walmart/Sam’s Club are preferred pharmacies in the Humana-Walmart Rx Plan. These plans’
annual costs are shown on page 4 of your evaluation.

For the Advantage plans, the AARP Medicare Complete Secure Horizons Plan 2 has zero costs if
you get mail-order refills of simvastatin – there are no Rx drug premiums and no co-payments.
This plan does not have preferred pharmacies, but when you need short-term prescriptions you
should make sure that the pharmacy you choose is in this plan’s network (the pharmacy will
know).

The other Advantage plan, the Humana Choice PPO Plan, has substantially higher costs for the
one Rx drug that you take. That’s because this plan has a $27.80 monthly premium for Rx drug
coverage. Advantage plans that include drug coverage have two premiums – one for health
coverage and the other for Rx drug coverage – and you pay the combined amount. This plan,
for example, has a $39.20 monthly premium for health coverage and a $27.80 monthly
premium for Rx drug coverage. People in this plan, then, pay $67 a month, which is the
combined premium for health and Rx drug benefits.

Richard, please let me know if you have any questions. There are a couple of things to keep in
mind as you make the transition to Medicare as your primary coverage. On your initial visits to
your p;roviders after September 1, show the office staff your enrollment cards for Medicare

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