Page 52 - Cover Letter and Evaluation for Bob Workman

10/25/2017 Your Plan Results
Retail $30.00 Health Plan Doctor Choice: $7,330 Enroll
Annual: $3,624 Deductible: $0 Plan Doctors for Includes $3,624
Part B Most Services for drug costs 3.5 out of 5
Premium stars
Reduction Out of Pocket
:No Spending Limit:
$6,700 In-
network

Kaiser Permanente Medicare Advantage Basic (HMO) (H5050-001-
0)
Organization: Kaiser Foundation Health Plan of Washington
Estimated Annual Monthly Deductibles: Health Benefits: Estimated Overall Star
Drug Costs: [?] Premium: [?] [?] [?] Annual Health Rating: [?]
and Drug Costs:
[?]
Retail $109.00 Health Plan Doctor Choice: $8,000 Enroll
Annual: $3,624 Deductible: $0 Plan Doctors for Includes $3,624
Part B Most Services for drug costs 4.5 out of 5
Premium stars
Reduction Out of Pocket
:No Spending Limit:
$2,000 In-
network

Asuris TruAdvantage Basic (PPO) (H5010-001-0)
Organization: Asuris Northwest Health
Estimated Annual Monthly Deductibles: Health Benefits: Estimated Overall Star
Drug Costs: [?] Premium: [?] [?] [?] Annual Health Rating: [?]
and Drug Costs:
[?]
Retail $87.00 Health Plan Doctor Choice: $8,000 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 $10,000 In and
Out-of-network
$6,700 In-
network

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.

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