Page 2 - Rx Drug Plan review for John

Hydrochlorothiazide (brand name Hydrodiuril) is one of the drugs that’s not covered. The
footnote says it’s because the plan does not cover it at the frequency that you take it – which is
one-half tablet each day, or 30 tablets every two months. But the plan will cover it at a lower
frequency, although you would need to contact the plan to find out what the maximum
frequency is. Because hydrochlorothiazide is so inexpensive, it might not be worth the trouble
to request an exception for this drug. The plan charges only $6.04 for 30 tablets. Whether you
buy it through the plan or get it on your own, the money you spend on this drug will not count
toward the deductible unless the plan approves it.

The other drug that is not covered by the plan is potassium chloride, which costs $58.37 a
month and is not on the plan’s formulary (the list of the drugs it covers). In this case, it might be
worthwhile to let the plan know you want to request a formulary exception for this drug. Your
doctor will then have to write an explanation of why you need potassium chloride instead of
another drug used to treat the same condition that the plan does have on its formulary. If your
request is successful, it could save you roughly $400 a year.

Medigap policy

John, as you know you can switch your Medigap policy to another company each year during
the 60 days following your birthday. Medigap Plan F premiums are listed in Appendix C2, and in
most cases these should be current premiums. It looks as though you can get a Plan F policy for
$190 a month or perhaps slightly less. But it may not make sense to switch for just a few
dollars, which could be the result of timing differences in when the insurance companies raise
their premiums (some may do it in July, others in December or January, etc.).

The telephone numbers of the companies that sell Medigap policies in California are in
Appendix C1. The plans’ premiums are also listed here, but many of these appear to be out of
date.

If you do decide to switch, be sure to let your current Medigap insurer know that you will be
switching your policy to another insurance company on a certain date.

Let me know if you have questions.

Sincerely,

David