Page 85 - Cover Letter and Evaluation for Dr. Herman Kensky

11/8/2017 Your Plan Results
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $17.80 Annual Drug Deductible: All Your Drugs on Enroll
Annual: $213.60 $405 Formulary :N/A
3.5 out of 5 stars
Mail Order Drug Copay/ Coinsurance: Drug Restrictions: N/A
Annual: N/A $0 - $47, 25% - 42%
MTM Program : Yes

SilverScript Choice (PDP) (S5601-020-0)
Organization: SilverScript
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $19.60 Annual Drug Deductible: $0 All Your Drugs on Enroll
Annual: $235.20 Formulary :N/A
Drug Copay/ Coinsurance: 4 out of 5 stars
Mail Order $3 - $43, 33% - 47% Drug Restrictions: N/A
Annual: N/A
MTM Program : Yes

Humana Walmart Rx Plan (PDP) (S5884-156-0)
Organization: Humana Insurance Company
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $20.40 Annual Drug Deductible: All Your Drugs on Enroll
Annual: $244.80 $405 Formulary :N/A
3.5 out of 5 stars
Mail Order Drug Copay/ Coinsurance: Drug Restrictions: N/A
Annual: N/A $1 - $4, 21% - 35%
MTM Program : Yes

Express Scripts Medicare - Saver (PDP) (S5660-226-0)
Organization: Express Scripts Medicare
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $22.60 Annual Drug Deductible: All Your Drugs on Enroll
Annual: $271.20 $405 Formulary :N/A
4 out of 5 stars
Mail Order Drug Copay/ Coinsurance: Drug Restrictions: N/A
Annual: N/A $1 - $4, 18% - 45%
MTM Program : Yes

Aetna Medicare Rx Saver (PDP) (S5810-044-0)
Organization: Aetna Medicare
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $23.80 Annual Drug Deductible: All Your Drugs on Enroll
Annual: $285.60 $350 Formulary :N/A
3.5 out of 5 stars
Mail Order Drug Copay/ Coinsurance: Drug Restrictions: N/A
Annual: N/A $1 - $30, 26% - 35%
MTM Program : Yes

Symphonix Value Rx (PDP) (S0522-014-0)
Organization: UnitedHealthcare
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:

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