Page 4 - Cover letter and evaluation for Thomas Barr

answering health questions (although if you later wanted to return to a Medigap policy, you
would likely have to answer these questions).

The other negative about this plan is its $41.30 monthly Rx drug premium, which is expensive
for someone who takes only one generic drug. That high premium is partially offset by the
plan’s low $5.70 monthly premium for medical benefits. This plan has a network of more than
9,000 providers, which would give you a wide range of choices if you wanted to go to another
doctor.

Drs. Dabbs and Kennedy are not listed in this plan’s network, but your other three physicians
are listed. Sometimes the online provider directories that we rely on are out of date, and so it’s
possible that one or more of these network listings is incorrect (the best way to verify whether
a doctor is in an Advantage plan’s network is to ask the doctor’s office).

Rx Drug Plan Coverage

As mentioned, if you buy a Medigap policy you will also need to enroll in a Part D stand-alone
plan. Because Medicare’s Part D does not cover over-the-counter drugs like aspirin and
benadryl, of the drugs that you take only simvastatin is covered.

The lowest-cost Part D stand-alone plan for simvastatin is the Envision Rx Plus prescription drug
plan. Broadneck Pharmacy is not a preferred pharmacy in this plan’s network, and you will get
lower prices at a preferred pharmacy such as CVS. Estimated annual costs, including premiums,
deductible, and co-pays, are $196 at Broadneck Pharmacy, $163 at CVS, and $151 if you get
mail-order refills. In the cost breakdowns on page 3 of the evaluation, I used the $163 number.
This plan’s coverage details and its estimated costs for your Rx drugs are shown in Appendix D2.

You can enroll in a Part D plan by calling the plan’s toll-free number, shown on page 4 and in
Appendix D2. In some cases, it may be possible for your current Rx drug plan to transfer your
prescription to your new plan. If not, of course, you’ll need to ask your doctors for a new
prescription.

If you were to choose the Johns Hopkins MD PPO plan, due to its high Rx drug premiums your
estimated annual costs at any local pharmacy would be $512, with mail-order refills being only
a few dollars less expensive.

Analysis

As you can see from the cost comparisons on page 3 of your evaluation, your fixed (or
minimum) costs will be roughly $2,000 less in the Advantage plan than in Plan F). But in Plan F
you will have no additional costs for Medicare-covered services, whereas in the Johns Hopkins
Advantage MD PPO plan you will have various co-payments, including 30% of cost for most out-
of-network services.

4