Page 4 - Cover Letter and Medicare Evaluation for Michael Bichy

adding the$240 in co-payments to the $226 Part B deductible, you’ll save $230 -- $700
in premium savings minus $466 for co-payments and the Part B deductible. But if you
average seeing your physicians twice a month, you’ll pay slightly more than you would
with Plan F.

If changing to a lower-premium plan is an option you want to explore, you might call
UnitedHealthcare (or the insurance agent who sold you your Plan F policy) to get a current
quote for Plan G or Plan N and to verify that you can switch without going through medical
underwriting. If you do need to be medically underwritten, you’ll likely have no problems in
qualifying (AARP’s underwriting guidelines are among the most lenient). And if you switch,
you’ll be in a plan that is not going to be phased out. Phone numbers for the insurers licensed
to sell Medigap policies in Delaware are on the first two pages of Appendix B1.

The pricing of Medigap policies
As noted, CSG Actuarial’s premium comparisons in Appendix B1 and Appendix B2 show
premium quotes for Plan F and Plan N. Also, if you’d like to see quotes for Plan G, let me know.
CSG Actuarial is a quoting service for insurance agents, and in some cases the premiums shown
in the appendices may not include an agent’s commission (I don’t know which ones they are).
But for most companies, including AARP, the premiums should accurately reflect what you will
pay. Also, if you talk to an agent, verify that you and Dottie are both receiving the 5%
household discount on your monthly premiums.

Comparing two Medicare Advantage plans

The two Advantage plans in your evaluation have your providers (or the Beebe Medical Group)
listed in their networks (Appendix A). But before you enroll in an Advantage plan, you should
check with your doctors’ offices to make sure that they will accept these plans, since the
provider directories are sometimes out of date. Also, both plans include Part D coverage, which
you are required to have to avoid future penalties.

1) Humana Gold Plus HMO-POS Plan. This is an HMO plan with a point-of-service (POS)
option. In limited situations, HMO-POS plans enable you to be covered when you go to
an out-of-network provider, although you will usually have higher co-payments. HMO-
POS plans have some leeway in designing their out-of-network coverage rules, but in
most cases your primary care provider will need to refer you for out-of-network care.

This plan has an excellent Medicare quality rating of 4.5 out of 5 stars, which is a strong
indicator of a well-run plan that provides quality medical care and earns high customer
satisfaction scores. This plan has zero premiums for health and Rx drug coverage, no
medical deductible, and no co-payments for in-network primary care visits. It also has a
relatively low out-of-pocket limit ($3,650) for in-network medical costs. And it offers
some dental and vision benefits. This plan and the AARP Medicare Advantage Choice
Plan 1 (PPO) below both have substantially lower costs for the Rx drugs you take than

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