Page 5 - Cover Letter and Medicare Evaluation for Michael Bichy

does the lowest-cost Part D stand-alone plan. This plan’s benefit summary is in
Appendix C1.

2) AARP Medicare Advantage Choice Plan 1 (PPO). This plan’s quality rating is an above-
average 4 out of 5 stars. Its benefit design is similar to the Humana plan’s above – no
premiums for health and Rx drug coverage, no medical deductible, and no co-pays for
primary care doctors’ office visits. Most Advantage PPO plans have high out-of-pocket
(OOP) limits, and while this plan’s OOP limits are higher than the Humana plan’s, they
are reasonable for a PPO -- $5,900 for network costs and $8,950 for in- and out-of-
network costs combined.

For some out-of-network services, this plan requires that you pay 40% of the cost, and
so there is a strong incentive to use only network providers. Like most other Advantage
plans, this plan offers dental, vision, and hearing benefits and some coverage for foreign
travel emergencies (similar to the Humana plan). This plan’s benefit summary is in
Appendix C2.

Risk Assessment

Your minimum costs in each coverage option are shown on page 3 of your evaluation.
Minimum costs are the costs you know you’re going to pay – your premiums, the co-payments
for the Rx drug you take, and the deductibles (it is assumed that you will pay the deductibles).
Of the plans compared in your evaluation, only Plan F has a medical deductible ($266) and only
the AARP MedicareRx Walgreens stand-alone drug plan has a drug deductible ($350).

These are the minimum costs for each option in 2023 (as shown on page 3 of your evaluation):

Medigap Plan F + AARP MedicareRx Walgreens drug plan $4,832
Medigap Plan N + AARP MedicareRx Walgreens drug plan $4,358
Humana Gold Plus HMO-POS Plan (Rx drugs included) $2,132
AARP Medicare Advantage Choice Plan 1 PPO (Rx drugs included) $2,165

So, there’s a $2,600+ difference in minimum costs between Plan F and either of the Advantage
plans. And a $2,200+ difference between Plan N and the two Advantage plans. During the year,
of course, those differences may be reduced as you make co-payments in your Advantage plan.

One way to think about the difference between Advantage plans and Medigap policies is that in
a Medigap policy you pay high premiums to give you a wider choice of providers and to reduce
your co-payments and out-of-pocket risk.

Rx Drug Plan Coverage

Please check the list of Rx drugs on the first page of Appendix D1 to make sure I entered them
correctly – this is the list that I typed into Medicare’s Plan Finder program, which then

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