Page 3 - Cover Letter and Evaluation for John

Two of your doctors accept Medicare-approved rates

Drs. Gibson and Truong accept Medicare-approved rates as payment in full, as shown in
Appendix A. Dr. Natale may or may not accept Medicare-approved rates, which means that in
some cases he can charge up to 15% more than the approved rates. Plans F and B both cover
this additional 15% charge.

The Medicare Advantage plan in your evaluation

Even though an Advantage plan is not a good choice for you, I thought I’d include one
Advantage PPO plan in your comparisons. As you can see on pages 2-3 of the comparisons, its
coverage is not that great. But it’s the only Advantage PPO plan in your area. If in a year or two
you were willing to switch to an Advantage HMO plan, you would save quite a bit on Rx drugs
but you could use only network doctors except in emergencies.

Rx Drug Plan Coverage

As mentioned earlier, if you buy a Medigap policy you will also need to enroll in a Part D stand-
alone plan. Because you are going to be enrolled for the last two months of this year as well as
2019, I looked for the lowest-cost plans each year.

Next year (2019), the lowest-cost plan is the AARP Medicare Rx Walgreens plan. This plan will
cost an estimated $3,056 for your drugs in 2019. That is an estimate of your total costs –
premiums, deductible, and co-payments. To get the lowest costs, you will need to get monthly
refills at a Walgreens pharmacy. To enroll in this plan, you can call its toll-free number shown
on page 4 of your comparisons.

For the last two months of this year, the lowest-cost plan is the Blue Shield Rx Enhanced Plan.
Its estimated costs are $432 for the last two months if you get monthly refills at a CVS
Pharmacy. The AARP Medicare Rx Walgreens plan, which is the lowest-cost plan for 2019, is
$200 more expensive for the last two months of this year than is the Blue Shield plan.

You can, then, enroll in the Blue Shield Rx Enhanced plan effective November 1 by calling the
plan’s toll-free number shown on page 4 of the comparisons. Then during the first week of
December you would call the AARP Medicare Rx Walgreens plan to enroll for the 2019 plan
year. If you do this, you do not need to let the Blue Shield plan know you are switching –
Medicare will do that once it knows you have enrolled in the AARP plan.

When you change prescription drug plans, the plan you are leaving is supposed to transfer your
prescriptions to your new plan (unless you are changing your refill schedule). But I’ve heard
that doesn’t always happen, so there’s a possibility you would have to get another set of
prescriptions from your doctors. But hopefully not.

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