Page 48 - Cover Letter and Evaluation for Bob Workman

10/25/2017 Your Plan Results

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Your Plan Results
Zip Code: 99206
Current Coverage: Original Medicare
Current Subsidy: No Extra Help [?]
Drug List ID: 7744939488
Your plan results are organized by plan type and are initially sorted by lowest Password Date: 10/23/2017
estimated cost. To view more plans, select View 20 or View All. Select any plan Important Coverage Information
name for details. Compare up to 3 plans by using the checkboxes and selecting
Compare Plans. The costs displayed are estimates; your actual costs may vary.

You are now viewing 2018 plan data. View 2017 plan data.

These are the Medicare Advantage plans
in your zip code that have the lowest
Symbols
annual costs in 2018 for the Rx drugs
that you take. The plans are listed in the
Some Dental Coverage Some Vision Coverage Nationwide Coverage Some Hearing Coverage
order of their annual costs, with the
lowest-cost plans listed first.
Your Current Plan(s)
Original Medicare (H0001-001-0)
Includes Part A (Hospital Insurance) and/or Part B (Medical Insurance) - Excludes Part D Drug
Coverage
Estimated Monthly Deductibles: Health Benefits: [?] Drug Coverage [?] Estimated Overall Star
Annual Drug Premium: [?] and Drug , Drug Restrictions Annual Health Rating: [?]
Costs: [?] [?] Copay [?] / [?] and Drug Costs:
Coinsurance: [?]
[?]
Retail Standard Part B Doctor Choice: Any N/A $7,500 Not Available
Annual: $3,624 Part B: Deductible: $183 Willing Doctor Includes $3,624
$134 for drug costs
Out of Pocket Spending
Limit: Not Applicable

I did not consider Advantage
Medicare Health Plans with Drug Coverage
HMO plans because of their
network restrictions and the
15 plans were found in 99206 based on your search criteria. View 10 View 15
fact that you will have to pay
full cost if you see a non-
Sort Results by network doctor (unless it's
Humana Gold Plus H5619-060 (HMO) (H5619-060-0) an emergency).
Organization: Arcadian Health Plan, Inc.
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall Star
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Rating: [?]
Costs: [?] [?] Copay [?] / Restrictions [?] Health and
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $0.00 Annual Drug Doctor Choice: All Your Drugs on $3,910 Enroll
Deductible: Plan Doctors Formulary :Yes
Pharmacy Drug: $0.00 $180 for Most 4 out of 5
Status: Health: Services Drug Restrictions: stars
Preferred Cost- $0.00 Health Plan Yes
Sharing Deductible: $0 Out of Pocket Lower Your Drug
Part B Drug Copay/ Spending Costs
Annual: $300 Premium Coinsurance: $4 Limit: $5,900
Reduction - $100, 29% In-network MTM Program :
Mail Order :No Yes
Annual: $143

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