Page 46 - Appendices for Barbara Pender
P. 46
MONTHLY PREMIUM
$0.00 Includes: Health & drug coverage
Doesn't include: $148.50 Standard Part B premium
YEARLY DRUG & PREMIUM COST
$0.00 Only includes premiums for the whole year when you don't enter any drugs
OTHER COSTS
$0 Health deductible
$480.00 Drug deductible
$2,500 In-network Maximum you pay for health services
SCAN Classic (HMO) This plan is
compared in your
SCAN Health Plan | Plan ID: H5425-007-0 evaluation
Star rating:
MONTHLY PREMIUM
$0.00 Includes: Health & drug coverage
Doesn't include: $148.50 Standard Part B premium
YEARLY DRUG & PREMIUM COST
$0.00 Only includes premiums for the whole year when you don't enter any drugs
OTHER COSTS
$0 Health deductible
$0.00 Drug deductible
$499 In-network Maximum you pay for health services
