Page 95 - APPENDICES for Fred Falten
P. 95
28 Prescription Drug Plans available
Rockingham, NH
This is a list of the stand-alone drug plans that have the lowest
Showing 10 of 28 drug plans costs for your Rx drugs for the last 9 months of this year.
Anthem MediBlue Rx Enhanced (PDP)
Anthem / Anthem or Blue KC in Missouri | Plan ID: S5596-066-0
Star rating:
This plan is
MONTHLY PREMIUM compared in your
evaluation.
$19.60 Includes: Only drug coverage
YEARLY DRUG & PREMIUM COST
$212.40 Retail pharmacy: Estimated total drug + premium cost
$212.40 Mail-order pharmacy: Estimated total drug + premium cost
DEDUCTIBLE
$350.00 Drug deductible
Mutual of Omaha Rx Premier (PDP)
Mutual of Omaha Rx | Plan ID: S7126-071-0
Star rating:
MONTHLY PREMIUM
$23.90 Includes: Only drug coverage
YEARLY DRUG & PREMIUM COST
$251.10 Retail pharmacy: Estimated total drug + premium cost
