Page 4 - Cover Letter and Evaluation for Amy Prack

is shown in Appendix B2, where the first few pages indicate that Drs. Huff and Katz
are in this plan’s network (but verify that before enrolling).

2) AARP Medicare Complete Plan 2. In several respects this plan is similar to the
Humana Gold Plus HMO Plan – it has the same $4,500 out-of-pocket limit for
medical services, it has a very low premium ($5.80 a month), and a large number of
specialists, although they are spread over a larger area than in the Humana plan.

This plan does, though, have some limited dental and vision benefits that are
included in its coverage (that’s different than the Humana Gold Plus HMO plan in
which you pay an additional premium for supplemental dental coverage). A detailed
summary of this plan’s costs and coverage, including its dental/vision benefits, is
shown in Appendix B3.

3) Humana Choice PPO Plan. In Advantage PPO plans, you have the flexibility to see
virtually any doctor and have some coverage. This PPO plan is unusual because in
many cases you will pay the same amount regardless of whether you see an in-
network or out-of-network provider. As an example, if you go to a specialist for an
office visit, you will have the same $50 co-payment in either case. This plan has no
premiums and no deductible for health coverage.

As a rule, PPO plans have higher out-of-pocket limits than do HMO plans. This plan’s
$6,700 out-of-pocket limit is average for a PPO, although it is unusual that this limit
also includes out-of-network services. Most PPO plans have a lower OOP limit for
network services and a higher limit for in- and out-of-network services combined, As
is the case with the other Humana plan in the evaluation, supplemental dental
coverage can be purchased for an added premium.

Rx Drug Plan Coverage

Please check the list of your Rx drugs, dosages, and monthly quantities that’s attached to this
letter. These are the drugs and dosages used to estimate your drug costs and to find the lowest-
cost plans for your drugs. The retail prices shown on pages 3 and 4 of the evaluation are for
Giant Eagle Pharmacy, which is a preferred pharmacy in the two Humana plans (the AARP plan
does not have preferred pharmacies).

In all three Advantage plans, you may be able to reduce your drug costs if you are willing to
switch to mail-order refills (in which case you will need new prescriptions from your doctor).
The annual cost differences between getting monthly refills at Giant Eagle and getting mail-
order refills are shown on page 4 of the evaluation.

4