Page 1 - Cover Letter and Evaluation for Dr. Jim Fisgus

February 25, 2019

Dr. Jim Fisgus
10876 Hillside Road
Alta Loma, CA 91737

Dear Dr. Fisgus:

Your evaluation comparing your current coverage to other options is enclosed. In most cases
the costs shown in your evaluation are estimates for the 2019 plan year (the exceptions are co-
payment amounts). The evaluation compares your current Gensler dependent coverage with an
Aetna Medicare Advantage plan and two Medigap policies.

The evaluation does not include comparisons of dental and routine vision benefits, neither of
which are covered by Medicare. The Medicare Advantage Plan in your evaluation does have
supplemental dental coverage riders that you can purchase for an extra premium. If you decide
to discontinue your Gensler medical and Rx drug coverage, you might ask whether you can
continue with the Delta Dental and VSP vision plans.

You will likely save money and gain improved coverage by switching from your current Gensler
employee plan to Medicare. And once you’re enrolled in Part A and Part B, the best option for
your supplemental coverage is to acquire a Medigap policy and enroll in a Part D stand-alone
plan. Since Medigap policies do not cover prescription drug costs, people who have Medigap
policies are also required to enroll in stand-alone drug plans.

Before deciding to switch, though, you should factor in the amount you will pay in Part B and
Part D premiums. If you and your wife file a joint income tax return and your modified adjusted
gross income exceeds $185,000, you will pay an “income-related monthly adjustment amount,”
or IRMAA.

These are also known as “means-tested premiums,” and at higher income levels they may be
substantially greater than the standard Part B premiums shown on page 3 of your evaluation.
Modified adjusted gross income (MAGI) is the adjusted gross income shown on your tax return
plus certain deductions. A separate attachment explains how MAGI is calculated and the
amounts of the higher premiums at various income levels.

The options in your evaluation

In your questionnaire you indicated that you would like to see your current plan compared to
Advantage plans and Medigap policies. There’s only one Advantage PPO plan in your area – the
Aetna Medicare Choice PPO Plan – and so I chose it as an example of an Advantage plan’s