Page 5 - Cover Letter and Evaluation for Debbie Workman

Rx Drug Coverage

Please check the list of your Rx drugs, dosages, and monthly quantities attached to this letter to
make sure they are correct. This list is the one that was used by the Medicare Plan Finder to
estimate your drug costs for 2018.

The prescription drug costs shown below and on page 4 of your evaluation include premiums,
deductible, and co-payments for the four drugs that you take. Your costs, of course, will be
slightly less since you’ll be enrolled for only 11 months.

As you know, if you purchase a Medigap policy you will also need to enroll in a Part D stand-
alone plan. For the Rx drugs that you take, the lowest-cost stand-alone plan is the Envision
Medicare Rx Select Plan. If you get mail-order refills, annual costs for your drugs in this plan are
an estimated $223. Walgreens is not a preferred pharmacy in this plan, and so if you need
short-term prescriptions filled you should probably go to CVS, Rite-Aid, or Sav-On, all of which
are preferred pharmacies.

If you decide to enroll in an Advantage plan, your Rx drug coverage is included in your benefits,
i.e., you cannot unbundle it from the health coverage. In the Humana Gold Plus HMO plan,
your costs are only $40 for the entire year if you get mail order refills. As you can see in
Appendix B3, the annual cost is comprised of quarterly payments of $10. Because you won’t
enroll until February, you will have a 30-day supply of medicine left at the end of 2018 (that’s if
you fill all your prescriptions in February when you enroll). Walmart is a preferred pharmacy in
this plan, and you will likely get the best prices there when you need short-term prescriptions
filled.

In the other Advantage plan – the AARP Medicare Complete Plan 1 – the estimated 2018 costs
for your drugs if you get mail-order refills is $204. In this plan, there are no co-payments for the
Rx drugs you take if you get mail-order refills, and the entire cost is the plan’s $17 monthly
premium. This plan does not have preferred pharmacies, so you can go to Walgreens or almost
any other pharmacy and get similar prices when you need short-term prescriptions.

Analysis

As you can see by comparing each plan’s minimum costs on page 3 of your evaluation, you may
save quite a bit of money by choosing one of the Advantage plans. In HMO plans such as these
two, a key to keeping your costs low is to see only network providers (except in emergencies).

As people grow older and use more medical services, in some cases they may find Advantage
HMO plans too restrictive because they will likely have to get referrals before they can see
specialists. Also, certain treatments that they need may require prior approval by the plan. At
that point, some individuals switch to a Medigap policy.

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