Page 13 - APPENDICES for Vic Bosiger
P. 13
$2,948.38 Retail pharmacy: Estimated total drug + premium cost
Doesn't include: Health costs
OTHER COSTS
$0 Health deductible
$0.00 Drug deductible
$10,000 In and Out-of-network Maximum you pay for health services
$6,700 In-network
Optima Medicare Value (HMO)
Optima Medicare | Plan ID: H2563-009-0
Star rating: Coming Soon
This plan is
Star rating = 4 stars
MONTHLY PREMIUM compared in your
evaluation.
$0.00 Includes: Health & drug coverage
Doesn't include: $148.50 Standard Part B premium
YEARLY DRUG & PREMIUM COST
$2,973.24 Retail pharmacy: Estimated total drug + premium cost
Doesn't include: Health costs
OTHER COSTS
$0 Health deductible
$150.00 Drug deductible
$4,000 In-network Maximum you pay for health services
HumanaChoice H5216-248 (PPO) This plan is
Humana | Plan ID: H5216-248-2 compared in your
evaluation.
Star rating: Coming Soon This plan is 4 stars
