Page 3 - Cover Letter & Evaluation for Patricia Letizia

Her current plan: The Humana Choice PPO Plan (H5525-004). This is a Local PPO Plan, and Dr.
Kahn is listed in this plan’s network, as indicated in Appendix A. I could not find Dr. Baumann in
the provider directory, but that may be because she is part of the large OSF network. In some
cases, providers who belong to medical groups are not listed under their individual names.
In the event that Dr. Baumann is not in network, your mother is paying 50% of the cost of visits
to her office as well as for any treatments that the doctor provides. The easiest way to find out
if she is in the network is to call her office and ask.

This plan’s annual health premiums are roughly $1,000 more per year than they would be in
either of the Wisconsin plans discussed below. As for her Rx drug costs in her current plan, as
mentioned earlier she can save a substantial amount by switching to mail-order refills but to do
that she will need new prescriptions from her doctors.

Option One for a Wisconsin Advantage Plan: The Aetna Medicare Premier PPO plan. Drs Roth,
Sinopoli, and Well-Holtey are listed in this plan’s provider directory, but Dr. Thirumakizhmaran
is not, as shown in Appendix A. This plan has a smaller provider network that either of the other
two plans in Mrs. Letizia’s evaluation, but with more than 6,000 providers she will still have a
relatively wide choice of doctors if she needs to see another specialist.

In addition, if she goes to an out-of-network doctor in either of the Wisconsin plans, her costs
will be substantially lower than they are in her current Illinois plan (where she pays 50% of the
cost). Her prescription drug costs in this plan are $204 for 2019 – an estimate that includes her
premiums, deductible, and co-pays. CVS is a preferred pharmacy in this plan.

Option Two for a Wisconsin Advantage Plan: Network Health Medicare Go PPO plan. Drs
Roth, Sinopoli, and Well-Holtey are also listed in this plan’s provider directory, but again Dr.
Thirumakizhmaran is not (see Appendix A). Because out-of-network charges are not as steep as
in her current plan, this is not as much of an issue, but prior to enrolling in this plan she should
know which of her doctors are network providers. She can find this out by calling the doctors’
offices.

This plan’s out-of-pocket limit for medical services -- $5,900 a year – is the same whether the
services come from network or out-of-network providers. That’s an unusual feature for a PPO
plan, and it further reduces the risk of going outside of network.

In this plan to get the lowest costs for her prescriptions, she should get her monthly refills at
Walgreens. This plan’s estimated annual drug costs of $392 are the highest of the three plans,
but that is mostly offset by its low monthly premiums for health coverage. Also, in this plan she
can lower her annual costs to an estimated $306 by switching to mail-order refills.

Debbie, please let me know if you or your mother have any questions. Also, there are a couple
of things your mother should keep in mind if she moves to Wisconsin. On her initial visits to her
new physicians, she should show the office staff her enrollment cards for Medicare A&B and

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