Page 12 - Cover Letter and Medicare Evaluation for Eric Hartman

Your Prescription Drug Costs

These costs are for your prescription drugs and are based on the dosages and monthly quantities that
you use. These costs include premiums, deductible, and co-payments.

Pharmacy Information

When you need a retail prescription filled or refilled, you will
Client's pharmacy:
usually get the lowest prices at one of your plan's preferred
pharmacies, although some plans do not have preferred
Mail order and CVS
pharmacies.
Are mail-order and CVS preferred pharmacies in the following plans' networks?

SilverScript SmartSaver Prescription Mail-order and CVS are preferred pharmacies. Walgreens is
Drug Plan (PDP not in this plan's network.

Mail-order and CVS are preferred pharmacies. Walgreens is in
SCAN Venture Advantage Plan
the network but is not a preferred pharmacy.

Mail order, CVS, and Walgreens are all network pharmacies
Alignment Health PPO Advantage Plan
(this plan may not have preferred pharmacies)

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The lowest-cost Part D stand-alone plan for your drugs

SilverScript SmartSaver
Prescription Drug Plan (PDP
To enroll in a plan, call its toll-free
number (833) 526-2445

Est. annual costs for mail-order refills $134

Est. annual costs for retail refills at CVS $140

This plan's Medicare quality rating 3.5 out of 5 stars
Medicare Advantage plans' costs for your drugs

These two Medicare Advantage plans SCAN Venture Advantage Plan Alignment Health PPO
include prescription drug and medical Advantage Plan
coverage (800) 559-3500 (888) 979-2247

Est. annual costs for mail-order refills $0 $0

Est. annual costs for retail refills at CVS $0 $60

This plan's Medicare quality rating 4.5 out of 5 stars 3.5 out of 5 stars

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