Page 1 - Cover Letter and Appendices for Irene Ellsworth

November 13, 2019

TO: Mrs. Irene Ellsworth

Dear Mrs. Ellsworth:

Following is a brief summary of your current Medigap policy and prescription drug plan
coverage.

Your prescription drug coverage

Based on the costs shown by the Medicare Plan Finder, you can save more than $250 next year
by changing from your current prescription drug plan (PDP) to the Wellcare Wellness Rx Plan.
To get those savings, though, you will need to get your prescriptions filled at a Walmart
Pharmacy.

Most prescription drug plans designate certain pharmacies as “preferred pharmacies” where
you will get the lowest prices. Your current Express Scripts Medicare-Saver plan has designated
both CVS and Walmart as preferred pharmacies. The Wellcare Wellness Rx PDP, on the other
hand, has designated Walmart but not CVS as a preferred pharmacy in your area.

It’s possible that the Wellcare Wellness Rx Plan has other preferred pharmacies in your area,
but there’s no easy way to know that because the Medicare web site no longer lists all a plan’s
preferred pharmacies. If you want to see if this plan has other preferred pharmacies nearby,
you can call the Wellcare Wellness plan’s enrollment number below and ask.

If you decide to switch to the Wellcare Wellness Rx Plan, call (888) 293-5151 to enroll. As you
know, you’ll need to make this change no later than December 7. You do not need to dis-enroll
from your current Express Scripts plan. Medicare will dis-enroll you from your current plan at
the end of December after it has been notified that you have enrolled in the Wellcare Wellness
Rx Plan.

Also, please check the list of your Rx drugs, dosages, and monthly quantities in Appendix A1 to
make sure they are correct. This list was used by the Medicare Plan Finder to find the lowest-
cost plans for your drugs next year. Appendix A2 is a side-by-side comparison of your current
plan and the Wellcare Wellness Rx Plan, and Appendix A3 is a detailed benefit summary of the
Wellcare Wellness Rx Plan.