Page 14 - Cover Letter & Evaluation for Mr. Henry Stiepel

Your Prescription Drug Costs

These costs for your prescription drugs are based on the dosages and monthly quantities that you use.
These costs include each plan's premiums, deductible, and co-payments.

Pharmacy Information

Client pharmacy: Sav-On When you need a retail prescription filled or refilled, you will
usually get the lowest prices at one of your plan's preferred
pharmacies. A few plans, though, do not have preferred
Retail (monthly) pharmacies.

Is Sav-On a preferred pharmacy in these plans' networks? Other preferred pharmacies

Express Scripts Medicare-Saver Yes CVS and others
Prescription Drug Plan (PDP)

Clear Spring Health Premier Rx No CVS and others
Prescription Drug Plan (PDP)
y g
Lowest-cost stand-alone drug plans for 2021

Express Scripts Medicare-
If you get a Medigap policy, you will also Saver Prescription Drug Plan Clear Spring Health Premier Rx
need to enroll in a stand-alone drug (PDP) Prescription Drug Plan (PDP)
plan. To enroll, call the plan's toll-free
number
(866) 477-5704 (877) 317-6082

Monthly premium $26.50 $13.30

Est. annual costs for monthly refills at a $1,166 $1,308
Sav-On pharmacy

Est. annual costs for monthly refills at a
CVS pharmacy $1,188 $1,179

Est. annual costs for mail order refills NA NA

This plan is too new to be
This plan's Medicare quality rating 3.5 out of 5 stars
rated by Medicare

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