Page 1 - Cover Letter and Medicare evaluation for Mr. Rod Fallow

November 8, 2021

Mr. Rod Fallow
885 Los Altos Avenue
Los Altos, CA 94022

Dear Mr. Fallow:

Your Medicare evaluation is enclosed. The costs shown in your evaluation are estimates for the
2022 plan year. Medicare has not yet announced the Part B premium and deductible amounts
for 2022, so for those two items the 2021 amounts are used.

You can choose between two types of supplemental coverage – 1) a Medicare Advantage plan
that includes prescription drug benefits; 2) a Medigap policy and a Part D stand-alone plan.

In your questionnaire you indicated that you interested in comparing both these types of
coverage, and so your evaluation compares two Medicare Advantage plans and two Medigap
plans that will need to be combined with a stand-alone drug plan.

Your physicians’ network affiliations

As shown in Appendix A, Drs. Wendy Ni Ahn and Nilufer Vesuna are both listed as accepting
Medicare-approved rates. Dr. Field is not listed, but dentists rarely are because Medicare
doesn’t cover dental treatments. And I was unable to find either Dr. Renna or the Lifespan
Medicine group he is affiliated with. Since Dr. Renna’s office is in Southern California, it’s
unlikely he will be in the networks of any Advantage plans in Santa Clara County.

For that reason, you may not have any good Advantage plan choices. For your comparison, I
chose two Advantage HMO plans that have Dr. Vesuna in their networks. It’s possible that these
plans could work fairly well if Dr. Renna does not accept Medicare, since his services will not be
covered through any Advantage plan.

Also, the only two Advantage PPO plans in Santa Clara County do not have Dr. Vesuna or the
Palo Alto Medical Foundation listed in their provider directories. It’s generally not a good idea
to enroll in a PPO plan in which your primary care doctor is not in network (all her referrals for
tests and screenings would likely be considered out-of-network costs).

A Medigap policy (along with a stand-alone drug plan) appears to be your best option. Here is a
brief overview of how these policies work and their pros and cons: