Page 2 - Cover Letter and Evaluation for Craig Callan

Attached to this letter are two summaries of the Medicare and COBRA coordination rules.

Your coverage options

In your questionnaire you indicated that you are interested in Medicare Advantage plans, but
there are only 10 Medicare Advantage plans in Montgomery County, as shown in Appendix B1.
I’m not sure why there are so few Advantage plans in your area – nationally there are an
average of 24 plans per county -- and in Tampa, Florida, where you will be moving, there are 33
Advantage plans.

Two of the Advantage plans in Montgomery County are sponsored by Kaiser Permanente and
require that you use only Kaiser providers. Two other plans are sponsored by Erickson and are
limited to residents of the Erickson continuing care communities.

That leaves six Advantage plans – four HMO’s and two PPO’s – for you to consider. I was unable
to find Dr. Kundapur or Physician Associates in any of these six plans’ networks. As you know, in
an HMO if you see an out-of-network provider you will pay the full cost of the visit or treatment
except in emergencies. And in HMO’s it may be difficult to see a specialist unless you are
referred by your primary care physician, Dr. Kundapur. Therefore in an HMO you would
probably need to find a new primary care doctor.

The two Advantage PPO plans are both sponsored by Johns Hopkins and include all of your
doctors except for Dr. Kundapur, as shown in Appendix A2. I chose these plans for your
evaluation because they appear to be the only viable alternatives.

Sometimes the online provider directories for Advantage plans are out of date, and if you find
that one or more of these HMO plans includes all your doctors in its network, I’ll be glad to
include it in the evaluation. The simplest way to find out if a doctor is in a plan’s network is to
call his/her office and ask if the doctor accepts that plan. Or you can call the plan.

Because your Advantage plan choices are limited, the evaluation also includes two Medigap
plans – Plan N and the High-Deductible version of Plan F. As you probably know, Medigap
policies do not include prescription drug coverage and so you if you choose to get a Medigap
policy you will also need to enroll in a Part D stand-alone plan. Or if you decide to keep your
COBRA coverage and use its Rx benefits (which must be creditable coverage), you can delay
enrolling in the stand-alone plan until the COBRA coverage ends.

Here’s how to enroll in the supplemental plan(s) you choose.

 If you decide to enroll in an Advantage plan, you can call the plan’s toll-free
number shown on pages 2-3 of the evaluation. Make sure that the person you
speak with understands that you want your coverage to begin on the date that
you’ve chosen. As noted above, it’s a good idea to verify with your doctors that

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