Page 61 - Cover Letter and Evaluation for Bob Workman

10/25/2017 Your Plan Results
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $26.70 Annual Drug Deductible: All Your Drugs on Enroll
$405 Formulary :Yes
Pharmacy Status: 3.5 out of 5 stars
Preferred Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $0 - $31, 25% - 32% Lower Your Drug Costs
Annual: $463 MTM Program : Yes
Mail Order
Annual: $454
Express Scripts Medicare - Saver (PDP) (S5660-246-0)
Organization: Express Scripts Medicare
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $22.60 Annual Drug Deductible: All Your Drugs on Enroll
$405 Formulary :No
Pharmacy Status: 4 out of 5 stars
Preferred Cost- Drug Copay/ Coinsurance: Drug Restrictions: No
Sharing $1 - $4, 18% - 43% Lower Your Drug Costs
Annual: $571 MTM Program : Yes
Mail Order
Annual: $523
Aetna Medicare Rx Saver (PDP) (S5810-064-0)
Organization: Aetna Medicare
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $32.60 Annual Drug Deductible: All Your Drugs on Enroll
$320 Formulary :Yes
Pharmacy Status: 3.5 out of 5 stars
Preferred Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $1 - $30, 26% - 35% Lower Your Drug Costs
Annual: $596 MTM Program : Yes
Mail Order
Annual: $592
Cigna-HealthSpring Rx Secure (PDP) (S5617-148-0)
Organization: Cigna-HealthSpring Rx
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $28.70 Annual Drug Deductible: All Your Drugs on Enroll
$405 Formulary :Yes
Pharmacy Status: 2 out of 5 stars
Preferred Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $1 - $35, 25% - 40% Lower Your Drug Costs

Annual: $704 MTM Program : Yes
Mail Order
Annual: $654
WellCare Value Script (PDP) (S4802-135-0)
Organization: WellCare
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $37.20 Annual Drug Deductible: All Your Drugs on Enroll
$405 Formulary :Yes
Pharmacy Status: 2.5 out of 5 stars
Preferred Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $0 - $25, 25% Lower Your Drug Costs
Annual: $733 MTM Program : Yes

Mail Order
Annual: $657

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