Page 3 - Cover letter and evaluation for Jay Newman

frequently will likely save $200-$400 a year vs. the higher-premium Plan F. But you will
have co-payments from time to time. Estimated annual premiums are $2,625.

4) Medicare Plan L. This is the least comprehensive of the four Medigap plans compared in
the evaluation. One nice feature is its low $2,620 out-of-pocket limit – it is the only
Medigap plan in your evaluation that has an OOP limit. But the limit does not include
premiums and applies only to the services the plan covers. As an example, the Part B
deductible ($183 in 2018) is not covered by this plan and so any money you spend
toward the deductible will not apply to the out-of-pocket limit. Annual premiums for
Plan L are about $2,400, although in New York relatively few insurers sell this plan.

The pricing of Medigap policies

Premiums for the four Medigap plans in your evaluation are shown in Appendices B1 and B2.
Those in Appendix B1 are from the New York Department of Financial Services, and they were
current as of May 1. The premiums in Appendices B2, which are only for Plan F, are from CSG
Actuarial, a firm that provides quotes for insurance agents. Some of the premiums listed here
may be lower than you can get because commissions are not included (unfortunately, there’s
no way to filter these out or for me to know which ones they are).

CSG Actuarial’s premiums may be helpful in a couple of ways. First, they are listed from lowest
to highest and can serve as a starting point to identify the companies with lower premiums.
Second, CSG Actuarial also shows the insurance companies’ financial ratings by A.M Best and (in
the case of larger insurers) Standard & Poor.

The state of New York’s regulations on the pricing of Medigap policies gives consumers a great
deal of flexibility to switch from one Medigap plan to another or from one insurance company
to another without having to answer health-related questions. These regulations are
summarized in Appendix A2.

Rx Drug Plan Coverage

As you are aware, you will also need to enroll in what’s known as a Part D stand-alone plan. The
lowest-cost plan for the one Medicare-covered Rx drug that you take is the Envision Rx Plus
Plan (Cialis is not covered by Part D). Its enrollment number is (888) 377-1439.

Your estimated costs in 2018 if you were to get monthly refills at Bigelow’s Pharmacy are $326,
which includes premiums, deductible and co-payments. But Bigelow’s is not a preferred
pharmacy in the Envision Rx Plus Plan, and in 2018 you could save roughly $100 a year in this
plan by getting your refills at a CVS Pharmacy.

Since you won’t be enrolled until June 1, your savings by going to CVS for your monthly refills
will be less – approximately $60 for the remaining seven months of 2018. Also, if you were
willing to switch to mail-order refills, your annual costs in 2018 would have been even lower.

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