Page 51 - Cover Letter and Evaluation for Bob Workman

10/25/2017 Your Plan Results
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 $67.00 Annual Drug Doctor Choice: All Your Drugs on $4,450 Enroll
Deductible: $0 Plan Doctors Formulary :No
Pharmacy Drug: $51.60 for Most 3.5 out of 5
Status: Health: Health Plan Services Drug Restrictions: stars
Standard Cost- $15.40 Deductible: $0 No
Sharing Drug Copay/ Out of Pocket Lower Your Drug
Part B Coinsurance: $2 Spending Costs
Annual: $918 Premium - $47, 25% - Limit: $6,700
Reduction 33% In-network MTM Program :
Mail Order :No Yes
Annual: $902

Notes:
Your costs may be different depending on your Part B premium, any Part D penalty that may apply, and whether you qualify for
Extra Help from Medicare paying your drug costs.
The five Advantage plans
listed below do not include
Medicare Health Plans without Drug Coverage Rx drug coverage. If you
enroll in one of these plans
5 plans were found in 99206 based on your search criteria. you will also need to enroll in
a Part D stand-alone plan.
Sort Results by
HumanaChoice H5216-046 (PPO) (H5216-046-0)
Organization: Humana Insurance Company
Estimated Annual Monthly Deductibles: Health Benefits: Estimated Overall Star
Drug Costs: [?] Premium: [?] [?] [?] Annual Health Rating: [?]
and Drug Costs:
[?]
Retail $0.00 Health Plan Doctor Choice: $6,710 Enroll
Annual: $3,624 Deductible: $0 Any Doctor Includes $3,624
Part B for drug costs 4 out of 5 stars
Premium Out of Pocket
Reduction Spending Limit:
:No $4,500 In and
Out-of-network This is the plan
$3,600 In-
network that's compared in
your evaluation.

AARP MedicareComplete Essential (HMO) (H1286-003-0)
Organization: UnitedHealthcare
Estimated Annual Monthly Deductibles: Health Benefits: Estimated Overall Star
Drug Costs: [?] Premium: [?] [?] [?] Annual Health Rating: [?]
and Drug Costs:
[?]
Retail $0.00 Health Plan Doctor Choice: $7,100 Enroll
Annual: $3,624 Deductible: $0 Plan Doctors for Includes $3,624
Part B Most Services for drug costs 4 out of 5 stars
Premium
Reduction Out of Pocket
:No Spending Limit:
$5,500 In-
network

Community HealthFirst MA Plan (HMO) (H5826-006-0)
Organization: Community HealthFirst Medicare Advantage Plan
Estimated Annual Monthly Deductibles: Health Benefits: Estimated Overall Star
Drug Costs: [?] Premium: [?] [?] [?] Annual Health Rating: [?]
and Drug Costs:
[?]

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