Page 4 - Cover Letter & Evaluation for Blanca del Real

The three Advantage HMO plans in your evaluation all appear to be solid choices. They all have
four-star or higher quality ratings from Medicare, which among other things means that
customers in these plans are satisfied with them. They all have zero health plan premiums, zero
health plan deductible, and zero or very low annual costs for the seven Rx drugs you take. As
shown in Appendix A, Dr. Roberts is listed in all three of these plans’ provider networks, but you
should verify that prior to enrolling.

Moreover, all three of these plans have some limited benefits for dental and vision coverage,
and two of the plans also have supplemental dental coverage (as shown on page 2 of the
evaluation) that you can choose to get for an added premium. As far as I can tell, your current
Boeing plan does not have coverage for dental care or routine vision care, including eyeglasses.

The benefit details of these three plans are shown in Appendices C2, C3, and C4. Here are
overviews of each plan.

1) The Humana Gold Plus HMO Plan. This plan has more than 17,000 providers in Los
Angeles and Orange Counties, giving you a wide choice of physicians if you need to see a
specialist (although your primary care doctor will probably need to refer you). This plan
has a $1,300 out-of-pocket limit, which is the most you could spend for Medicare-
covered services (this plan has no premiums or deductibles). The OOP limit does not
include costs for Rx drugs, which in your case is not a factor because your annual drug
costs are zero in this plan.

2) The Blue Shield 65 Plus HMO Plan. This plan has more than 15,000 providers in Orange
County and portions of Los Angeles County. Its OOP limit is $999 for medical services
and its costs for your prescription drugs is $57 for the year, including premiums,
deductible, and co-payments. This plan has optional dental coverage that you can
acquire for an extra premium.

3) The SCAN Classic HMO Plan. This plan has a 4.5-star quality rating from Medicare, which
is slightly higher than the 4-star ratings of the other two plans. It has more than 6,500
providers in Los Angeles County, and its OOP limit is $1,000 in 2019. Its Rx drug costs are
$60 for the year, including premiums, deductible, and co-payments. This plan has an
optional dental supplement that you can purchase for an added premium.

Rx Drug Plan Coverage

Please review the list of your Rx drugs, dosages, and monthly quantities that’s attached to this
letter. This is a printout from the Medicare web site and was used to find the drug costs under
each plan. The costs shown assume you will continue to get monthly refills at a CVS pharmacy.

In your current Boeing plan, next year you will pay $10 a month for each generic drug. Since
you take seven drugs, all of them generic, your co-payments will be $70 a month or $840 a
year. This is clearly much higher than in any of the other options. As noted, it’s possible that the

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