Page 4 - Cover Letter and Evaluation for Bob O'Connell

companies offer these “household discounts,” the ones that do often have substantially
reduced premiums.

In addition, the UnitedHealthcare/AARP Medigap policies have an early enrollment discount
that in your case is 30% below AARP’s standard rate. The discount is calculated by multiplying
3% by the number of years that you are younger than 75. Your discount equals 10 years x 3%,
or 30%, and that discount will be reduced by 3% each year until you turn 75.

If you acquire an AARP Medigap policy, then, you may have two increases a year – one a 3%
increase associated with the reduced age discount (until you turn 75) and the other an increase
for health care inflation. AARP policies can be good choices if they are attractively priced, but
you should be aware that your premiums may rise more quickly than with many other insurers.
Once you turn 75, the AARP premiums may increase more slowly.

In addition to discounts, some insurers provide extra benefits such as membership in Silver
Sneakers, which give you access to more than 12,000 gyms and health clubs nationally.

Medicare-approved rates

As shown in Attachment A, all your physicians are listed on the Medicare web site as accepting
Medicare’s approved rates.

Rx Drug Plan Coverage

People who have Medigap policies are required to have Part D stand-alone plans. For your
prescription drugs, the lowest-cost plan in 2019 is the AARP MedicareRx Walgreens Prescription
Drug Plan, which you can enroll in by calling (800) 753-8004.

In this plan, your estimated annual costs in 2019 are $6,199. That assumes you will get your
prescriptions filled at a Walgreens pharmacy, which is one of this plan’s two preferred
pharmacies in your area. The estimated annual costs include premiums, the plan’s $415
deductible, and co-payments for your Rx drugs. Those costs are based on the drugs, dosages,
and monthly quantities shown on the attached list of your drugs as they were entered in the
Medicare web site.

One of your drugs – Cevimeline – is not on this plan’s formulary, (or list of covered drugs). The
Medicare web site indicates that none of the 28 Part D stand-alone plans in your zip code has
all your drugs on its formulary (in some cases, it could be a different drug that is not on the
formulary).

When a drug is not a plan’s formulary, there are two possible ways you might save money. The
first is to request a formulary exception from the plan. If you do that, your doctor will likely
need to justify your need for Cevimeline and not a similar drug. The other option is to buy
Cevimeline from a discount pharmacy, which will save you roughly $1,000 a year. There is no

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