Page 54 - Cover Letter and Evaluation for Bob Workman

10/25/2017 Your Medicare Health Plan Details

Your Plan Details

Zip Code: 99206
Current Coverage: Original Medicare
Current Subsidy: No Extra Help [?]
Select the tabs below for more detailed information about the plan health benefits, drug costs Drug List ID: 7744939488
and more coverage and star ratings.
Password Date: 10/23/2017
Important Coverage Information

Symbols
A process through which the physician or other health care provider is required to obtain advance approval from the plan that payment
will be made for a service or item furnished to an enrollee. Unless specified otherwise with respect to a particular item or service, the
enrollee is not responsible for obtaining (prior) authorization.
Some Dental Coverage Some Vision Coverage Some Hearing Coverage
* Estimated

HumanaChoice H5216- 500 West Main Street Overall Star Rating: [?] Enroll
Louisville, KY 40202
046 (PPO)
(H5216-046-0) 1 Members: 4 out of 5 stars
1-800-457-4708
Organization: Humana Insurance 711 (TTY/TDD)
Company
Non Members:
Plan Type: Local Preferred 1-800-833-2364
Provider Organization 711 (TTY/TDD)

Additional Plan Information

Overall Star Rating [?]
4 out of 5 stars

Health Plan Star Ratings [?]
3.5 out of 5 stars

Drug Plan Star Ratings [?] Not Applicable

Plan Type: Local Preferred Provider Organization
Plan Status: Approved by Medicare
Area: Select Counties in ID, OR, WA and UT

View plan website 
Important Note:

https://www.medicare.gov/find-a-plan/results/planresults/plan-details.aspx?cntrctid=H5216&plnid=046&sgmntid=0 1/2