Page 3 - Cover Letter and Evaluation for Clay Bassett

Medigap premiums are listed in Appendices B1 through B4, and the phone numbers of the
carriers that sell Medigap policies are listed in Appendix B5.

All your doctors agree to accept Medicare-approved rates

When providers do not accept Medicare-approved rates, they can charge up to 15% more.
Plans F and G cover this additional 15% surcharge, but Plan N does not. In your case, this isn’t
an issue -- Appendix A shows the Medicare web site’s printouts indicating that your doctors
accept assignment.

The Medicare Advantage plan in your evaluation

There are three Advantage PPO plans in your area but only one of them has out-of-state
providers in its network. That’s the AARP Medicare Complete Choice Regional PPO plan. As
shown at the end of Appendix C2, its network directory lists all your physicians, including the
two in Boston. Sometimes the network directories are out of date, though, and before enrolling
in an Advantage plan you should verify with your doctors’ offices that they still accept the plan.

This plan appears to be an attractive choice for you for several reasons. Probably most
important, all your doctors are listed in its network of more than 20,000 providers. It also has
an above-average 4-star quality rating from Medicare, a health plan premium of only $28.10 a
month ($337 a year), and no health plan deductible. When you see network providers, you will
pay $20 for a doctor’s office visit to your primary care provider and $45 to your specialists. In
most cases, you will pay 30% of the cost when you go out of network.

This plan’s negatives appear to be relatively minor, including annual prescription drug costs that
are approximately $50 more than you would pay in a Part D stand-alone plan. As in virtually all
Advantage plans, in this plan you take on a greater out-of-pocket risk than with a
comprehensive Medigap plan. Here, the plan’s out-of-pocket limit is $5,500 if you use only
network providers and $10,000 for in- and out-of-network services combined. These out-of-
pocket limits do not include plan premiums or prescription drug costs.

Rx Drug Plan Coverage

As noted earlier, if you buy a Medigap policy you will also need to enroll in a Part D stand-alone
plan. Because you take only one drug – Valsartan (generic for Diovan) – your costs are low in
any of the options compared in the evaluation. In 2018 the lowest-cost stand-alone plan for
your Rx drug is the Envision Rx Plus plan. For mail-order refills, this plan would cost only $187
for the 2018 plan year, including premiums and co-payments. CVS is a preferred pharmacy in
this plan, and if you needed to get short-term prescriptions filled you would likely get the
lowest prices at a CVS pharmacy.

In the AARP Medicare Complete Choice Regional PPO plan, your annual costs this year would be
an estimated $239 for mail-order refills. This plan does not have any preferred pharmacies.

3