Page 1 - Cover Letter & Evaluation for Patricia Letizia

October 15, 2018

Mrs. Deborah Janke
P. O. Box 2004
Brentwood, TN 37024

Dear Mrs. Janke:

Attached is the Medicare evaluation for your mother, Mrs. Patricia Letizia. Please check the
information on the client data sheet on page 5 to make sure it is correct, as well the attached
lists of the prescription drugs that she takes -- their names, dosages and monthly quantities.
There are two Rx drug lists – one for Peoria and the other for New Berlin – but the information
should be the same on both.

Another attachment to this letter summarizes Medicare’s special enrollment period rule when
people move outside of their current plan’s coverage area. Mrs. Letizia will have a guaranteed
right to purchase a Medigap policy or enroll in another Medicare Advantage plan during this
special enrollment period, and she should make sure that there is no lapse in her coverage, i.e.,
her new coverage should begin the day after her current coverage ends. Her new plans may ask
for proof that she is currently covered in Illinois. The other attachment to this letter shows the
benefit design of Wisconsin’s Medigap policies.

In most cases the costs shown in the evaluation are estimates for the 2019 plan year.

Medigap policies

You indicated that your mother wishes to consider Medigap policies as well as Advantage plans.
Wisconsin is one of three states that have their own standardized Medicare supplemental plans
(or Medigap policies), and the benefit design that is attached to this letter is unique to
Wisconsin. Even so, those benefits are good in all 50 states.

Wisconsin’s Medigap benefit design consists of a basic plan that can be augmented by riders
that plug some of the remaining gaps. There are seven riders, although a couple of them are
mutually exclusive, e.g., one rider covers the $1,364 Part A deductible in case she is
hospitalized, while another covers only 50% of the Part A deductible and therefore has a lower
premium.

There are at least two of these riders that would probably not be cost-effective for her to get –
the excess charges rider and the Part B deductible rider (in 2019 the Part B deductible is $185).