Page 12 - Cover Letter and Medicare Evaluation for Donald Pender
P. 12

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


                     Client's pharmacy:             When you need a retail prescription filled or refilled, you will
                                                    usually get the lowest prices at one of your plan's preferred
                          Rite Aid                  pharmacies (some plans do not have preferred pharmacies).

                                  Which pharmacies are the plans' preferred pharmacies

           Humana Walmart Value Rx Prescription        Rite Aid is in this plan's pharmacy network but is not a
                                        Drug plan                preferred pharmacy (Walmart is).


                                                   Rite Aid, CVS, and Walmart are all standard pharmacies in this
                   Platinum Advantage HMO Plan
                                                                               plan


                                                   Rite Aid is not a preferred pharmacy in this plan, but CVS and
          Blue Shield 65 Plus Advantage HMO Plan
                                                                           Walmart are


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

                                                    Humana Walmart Value Rx
                To enroll in a plan, call its toll-free
                                          number       Prescription Drug plan
                                                          (800) 706-0872
              Est. annual cost at Rite Aid (including
                                       premiums)               $401

                                 Mail-order refills            $399


                This plan's Medicare quality rating       4 out of 5 stars

                                   Medicare Advantage plans' costs for your drugs

             These two Medicare Advantage plans
            include prescription drug  and  medical   Platinum Advantage HMO      Blue Shield 65 Plus Advantage
                                                                                            HMO Plan
                                                               Plan
                                        coverage
              Est. annual cost at Rite Aid (including           $0                            $144
                                       premiums)

                                 Mail-order refills             $0                             $30

                This plan's Medicare quality rating       4 out of 5 stars               4 out of 5 stars


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