Page 5 - Cover Letter and Medicare Evaluation for Mrs. Jane Miller

plans include dental benefits, some worldwide coverage for medical emergencies, and health
club memberships.

1) AARP Medicare Advantage Choice PPO Plan. This is the only Advantage plan that I
found that has all your physicians listed in its network (as shown in Appendix A2). Again,
though, before enrolling in an Advantage plan it’s important to make sure that’s the
case.

This plan has several attractive features, including zero deductibles for both medical and
Rx drug coverage. And unlike many other Advantage PPO plans, this plan has fixed co-
payments for out-of-network doctors’ office visits -- $45 to see an out-of-network
primary care doctor and $70 to see an out-of-network specialist. That’s in contrast to
the Aetna Medicare Value PPO Plan in which you will pay 40% of cost. In that plan, for
instance, you will pay $80 for an office visit to a specialist who charges $200 per visit
(some charge more).

Almost all Advantage PPO plans have high out-of-pocket limits, especially if you see
providers who are not in the network. This plan has a $5,900 network out-of-pocket
limit, but if you go outside the network those payments count only toward the higher
$10,000 in- and out-of-network limit.

As mentioned, this plan and the Aetna Medicare Value PPO Plan have good dental
benefits and some vision coverage. If you are considering enrolling in this plan, you
might check with your dentist to make sure that he/she will accept its dental coverage.

2) Aetna Medicare Value PPO Plan. This plan is a less desirable choice for several reasons.
It has a $1,000 medical deductible, and so you will pay for the first $1,000 in doctors’
office visits and other services (exceptions are those services like recommended
preventive tests that Medicare covers at 100% and that you receive in network).

Also, Dr. Chen is not listed in this plan’s network, and so you will pay 40% of the cost of
her services. Another problem is that this plan’s catastrophic coverage is weak -- $7,500
for network services and $11,300 for in- and out-of-network services.

You expressed an interest in high-deductible options, which can sometimes make financial
sense for people who do not use many medical services. Attached is some information from the
Medicare web site about Medical Savings Accounts, which are Advantage plans that give you an
up-front payment as a tradeoff for the high deductible. As you can see in Appendix C1, there
are two MSA plans in New Castle County, both new.

MSA plans are not available in many parts of the country, and a recent report indicated that
there are only a few thousand MSA enrollees nationwide (compared to roughly 25 million
people enrolled in Advantage plans).

5