Page 14 - Cover Letter and Medicare Evaluation for Andrea Masters
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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 a plan's preferred
pharmacies. Some plans, though, do not have preferred
CVS
pharmacies.
Is CVS a preferred pharmacy in the following plans' networks?
SilverScript Smart Rx Prescription Drug CVS is a preferred pharmacy in Walmart and Kroger are also
Plan (PDP) this plan preferred pharmacies
Neither are Walgreens or
CVS is not a preferred
CDPHP $0 Medicare Rx HMO Plan Walmart. This plan may not
pharmacy in this plan
have preferred pharmacies
Highmark Blue Shield Freedom Nation CVS is not a preferred Walgreens and Walmart are
PPO Plan pharmacy in this plan preferred pharmacies
The lowest-cost Part D stand-alone plan for your drugs
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Estimated retail costs for your drugs
To enroll in a plan, call its toll-free SilverScript Smart Rx Prescription Drug Plan (PDP)
number
(833) 526-2445
Annual premiums $86
Est. annual costs for monthly and mail- NA
order refills
This plan's Medicare quality rating 3.5 out of 5 stars
Medicare Advantage plans' costs for your drugs
These two Medicare Advantage plans CDPHP $0 Medicare Rx HMO Highmark Blue Shield Freedom
include prescription drug and medical Plan Nation PPO Plan
coverage (888) 519-4455 (888) 875-2232
Annual premiums $0 $0
Est. annual costs for mail-order refills NA NA
This plan's Medicare quality rating 5 out of 5 stars 5 out of 5 stars
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