Page 4 - Cover Letter and Medicare Evaluation for Vic Bosiger

benefits but gives you the option to buy a comprehensive dental supplement for a $38
monthly premium. A more detailed summary of this plan’s costs and benefits is in
Appendix B2.

2) Optima Medicare Value Advantage HMO Plan. This plan has an above-average
Medicare quality rating of four stars. It also has a much lower out-of-pocket limit --
$4,000 – than the other two plans in this evaluation. And like the other two plans, it has
some limited benefits for dental and vision coverage, as well as a $25 co-pay for a
hearing exam.

Similar to the other two plans in your evaluation, this plan has a zero co-pay for office
visits to your primary care physician. It also has a $20 co-pay for office visits to
specialists, which is the lowest of the three plans. You can see a more detailed summary
of this plan’s coverage in Appendix B3.

3) Humana Choice Advantage PPO Plan. This PPO plan gives you the flexibility to go to
doctors and other medical providers who are not in the plan’s network, but you will
usually pay more when you go outside the network. In this plan, for instance, you will
pay 40% of the cost when you go to an out-of-network doctor (emergencies are
exceptions).

This plan’s out-of-pocket limits are also high, which is not unusual for a PPO plan. It has
a $5.900 limit for network services (which is the same as the AARP plan in your
evaluation), but that limit jumps to $10,000 for combined in- and out-of-network
services. This plan has a good four-star quality rating. You can see a more detailed
summary of this plan’s costs and benefits in Appendix B4.

Rx Drug Plan Coverage

The list of your Rx drugs, dosages, and monthly quantities is in Appendix C. This is the list that
the Medicare Plan Finder program used to find the lowest-cost plans for your drugs. Aspirin
(81mg tablets) can be purchased over the counter and is not covered by Part D. Since you take
the nitroglycerin tablets only as needed, I entered 50 tablets a month, which is one-half the
standard dosage. And Prasugrel is the generic equivalent of Effient (you would likely have to
pay the full price if you purchased the brand-name version).

As you can see on page 4 of the evaluation, your estimated costs for these drugs are in the
$3,000 a year range. The AARP Medicare Advantage Plan 1 has the lowest estimated annual
costs at $2,948, followed closely by the Optima Medicare Value Advantage HMO Plan at $2,973.
The Humana Choice PPO plan’s estimated annual costs are somewhat more expensive at
$3,115. The fourth option is the Wellcare Value Script stand-alone drug plan, which you would
get if you were decide to get a Medigap policy.

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