Page 70 - Cover Letter and Evaluation for Bob Workman

10/25/2017 Your Medicare Health Plan Comparison

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Your Plan Comparison
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
and coverage and star ratings. Drug List ID: 7744939488
Password Date: 10/23/2017
Important Coverage Information

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

Symbols This is a comparison of the costs in your current
Silverscript Choice Plan and the Envision Rx Plus
Nationwide Coverage Plan, which has the lowest 2018 prices for the Rx
* Estimated drugs that you take. See the following page for the
cost comparisons.

SilverScript Choice (PDP) EnvisionRxPlus (PDP)

(S5601-060) Plan Type: (S7694-030) Plan Type:
Organization: SilverScript Organization: EnvisionRx Plus
Members: 1-866-235-5660 Members: 1-866-250-2005
711(TTY/TDD) 711(TTY/TDD)
Non Members: 1-866-552-6106 Non Members: 1-866-250-2005
711(TTY/TDD) 711(TTY/TDD)
Coverage: Provides drug coverage only. Coverage: Provides drug coverage only.
NOTE: Health Plan Benefits are based on Original Medicare NOTE: Health Plan Benefits are based on Original Medicare

To enroll, call this
number prior to
December 7. Your
new coverage will
go into effect
Fixed Costs
January 1, 2018.

Monthly Drug Plan Premium $30.40 Monthly Drug Plan Premium $12.60

Monthly Health Plan Premium N/A Monthly Health Plan Premium N/A
Annual Drug Deductible $0.00 Annual Drug Deductible $300.00
Medicare costs at a glance Medicare costs at a glance

Estimate of What YOU Will Pay for Drug Plan Premium and Drug Costs

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