Page 13 - Cover Letter and Evaluation for Forrest Hoover
P. 13
Plans that appear to meet your criteria (cont'd)
AARP Medicare
Complete Focus Humana Gold Plus
Plan name Medigap Plan G Medigap Plan N HMO Plan
PPO Plan (H5619-051)
(H2228-020)
Toll-Free Number NA NA (800) 555-5757 (800) 833-2364
Estimated annual premiums for medical coverage
lity ratings from Medicare web site (best rating = 5 stars)
2019 standard Part B
premium of $135.50 a $1,626 $1,626 $1,626 $1,626
month*
Health plan annual
premiums (Medigap $1,350 $600 $0 $0
premiums are estimates)
Total $2,976 $2,226 $1,626 $1,626
Minimum costs for Medicare-covered services
Total medical premiums $2,976 $2,226 $1,626 $1,626
(from above)
Plan health deductible
(includes Part B deductible if $185 $185 $0 $0
not covered by plan**)
Annual premiums for Rx
drug coverage $186 $186 $0 $0
Total Minimum Costs
(includes cost-sharing for the $3,347 $2,597 $1,626 $1,626
Rx drugs you now take)
Cost-sharing for doctors office visits
=
In-Network Primary
Care Co-Pays $5 $0
No co-pays for You pay 5% of
In-Network Specialist Medicare-covered Medicare approved
Co-Pays services amount $40 $40
Out-of-Network
Co-Pays $30 and $55 Not covered
*This is 2019 standard Part B premium for new enrollees who are not yet receiving Social Security benefits.
**Part B deductible in 2019 is $185.
3
