Page 4 - Cover Letter and Evaluation for Dr. Maury Rosenstein

health care inflation. AARP policies can be good choices if they are attractively priced, but your
premiums may rise more quickly than with many other insurers. These early enrollment
discounts are not available to New York residents.

Besides discounts, some insurers provide extra benefits such as membership in Silver Sneakers,
which give you access to more than 12,000 gyms and health clubs nationally.

Do your doctors accept Medicare approved rates?

Drs. Challa and Plakseychuk both accept Medicare-approved rates, as shown in Appendix A. As
you know, some doctors who accept Medicare do not accept Medicare-approved rates. In
those cases, doctors can charge up to 15% more than the approved rates. Plans F and G in your
evaluation cover the 15% surcharge but plans N and L do not.

Health Savings Accounts

Individuals are not supposed to contribute to Health Savings Accounts after they enroll in Medicare –
either Part A or Part B. On your questionnaire you indicated that you are currently contributing to an
HSA, and so you might be at a slight risk of a future task penalty. If in the future you drop Parts A&B, you
might be able to resume your HSA contributions, but you would need to verify that with your employer
and perhaps your tax advisor. Appendix C has a summary of the HSA rules as they apply to Medicare.

Two kinds of primary coverage

My understanding is that you are not retired and have health coverage through your employer plan. In
that case, you have two kinds of primary insurance, which is insurance that’s designed to be the first
payer. In my experience, the only people who have two types of primary insurance are those already
have primary insurance through an employer plan and who are unaware that when they sign up for Part
B, it is supposed to become their primary coverage.

You probably already know this, but there is a potential concern in having two kinds of primary
insurance. If either insurance pays for care that the other insurance could have paid for, the insurer
paying the claim may ask for reimbursement of costs that could have been paid for by the other insurer.

Medicare, for example, will sometimes try to recover costs that it has paid if it learns there is other
primary insurance that could or should have paid some those costs. Or, an employer plan might seek
reimbursement for costs that Medicare could have paid. This is a complex area that in some cases
depends on state laws, but it is a good idea to make sure this will not be an issue. Again, you may have
already checked into this, but in case you haven’t I thought I’d mention it.

Sincerely,

David Armes, CFP®

Appendices
WDA:12115

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