Page 1 - Cover Letter and Evaluation for Barbara Lesswing

November 20, 2017

Mrs. Barbara Lesswing
9834 Tottenham Avenue
Clarence, NY 14031

Dear Mrs. Lesswing:

Your Medicare evaluation is enclosed. Please check the information on the client data sheet on
page 5 to make sure it is correct. If you decide to change your current coverage, you will need
to do so no later than December 7, the date that Medicare’s annual open enrollment period
ends. Instructions about how to change your coverage at the end of this letter.

In most cases the estimated costs shown in your evaluation are for the 2018 plan year. Because
Medicare has not yet said how much the Part B deductible and various co-payments will be
next year, the 2017 amounts are used for Medicare cost-sharing on pages 3-4 and 6-7 of your
evaluation (the 2018 amounts are expected to be about 4%-5% higher).

Your current coverage

The Medicare Advantage plan you are presently enrolled in – the Independent Health
Association Encompass 65 Basic HMO plan – is in many respects an excellent plan with high
quality ratings from Medicare. It is not, however, a low-cost plan for the prescription drugs you
take. If you decide to remain in this plan next year, you can reduce your Rx drug costs by almost
$300 by switching to mail-order refills. But even after making that switch, this plan’s costs for
your Rx drugs are relatively high compared to those in other plans.

One approach you might consider is changing your coverage to a different Independent Health
Assocation Advantage plan – the Health Encompass 65 HMO plan. This plan’s name is similar
your current plan’s except that it omits the word “Basic.”

Unlike your present plan, the Health Encompass 65 HMO plan does not include prescription
drug coverage. In most Advantage plans, Rx drug coverage is included among the benefits, and
people cannot unbundle the drug coverage from the medical coverage. It’s not unusual, then,
for people to be in an Advantage plan has excellent medical coverage but that is too expensive
for the Rx drugs that they take. That’s your situation.

If you change to the Health Encompass 65 HMO plan, you will also need to enroll in a Part D
stand-alone plan. See the diagram that’s attached to this letter. As its name suggests, a stand-
alone plan does not have any medical benefits, covering only prescription drugs. In your case,
you can save a substantial amount on your prescription drugs if you are in the lowest-cost