Page 3 - Cover letter and evaluation for Michele Buros

in the appendices. Here are brief summaries of each plan, with additional detail available in the
appendices.

1) Community Blue Medicare PPO Signature Plan. This is a Highmark-sponsored plan,
and it appears that one or both of your doctors are not in its network, even though
they are listed in Highmark’s master directory. As mentioned earlier, it would not be
unusual for one or both of your doctors to be in the networks of some Highmark
plans but not others. If it turns out that neither of them is in network, this plan
might not be a good choice for you.

This plan has the lowest costs for your two drugs -- $155 in 2018 – an amount that
includes premiums and co-payments. And its health premium is only 10 cents a
month – an unusual amount that is the result of Medicare’s complex bidding process
which automatically sets plans’ premiums based on their bids.

In addition to low Rx drug costs, this plan’s minimum costs (shown on page 3) are
low -- $1,764 a year, an amount includes Part B premiums and your health plan’s
premiums and deductibles. That is the lowest minimum cost of any PPO option. A
plan’s minimum (or fixed) cost is the least amount you will pay, assuming you
continue to take your Rx drugs but do not go to your doctors. As you go to your
doctors and make co-payments, your costs increase.

2) Advantra Silver PPO Plan. Both of your doctors are listed in this plan’s provider
directory (but before enrolling, you should verify that). This is a plan that has a
$1,000 medical deductible. It could be appealing to someone in good health who
expects to use few medical services (and thus not spend the deductible amount). In
the cost comparisons on page 3 of the evaluation, I assumed that you will spend the
full deductible amount, but that is unlikely (particularly since you’ll be enrolled for
only 10 months this year).

If it turns out that both of your doctors are in network, your cost-sharing in this plan
is low -- $5 when you see Dr. Colangelo and $35 when you see Dr. Rygg. If either of
them orders diagnostic tests or specific treatments, those costs would also be
relatively low, assuming they are in the plan’s network. When you go out of network
in this plan, you pay a stiff 40% of the cost of the visit, test, or treatment.

3) Humana Value Plus PPO Plan. Dr. Colangelo is listed in this plan’s network but Dr.
Rygg is not. This plan has the second-lowest fixed or minimum costs – it has zero
premiums for health coverage and a health plan deductible of only $183, which
equals the amount of Medicare’s Part B deductible this year.

One unusual feature of this plan is that you will pay 20% of the cost for doctors’
office visits regardless of whether they are in the network. In addition, if you look in
Appendix D you will see that most medical services cost the same in network and

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