Page 162 - Cover Letter and Evaluation for Sue Marx

2/6/2019 Your Plan Results
Retail $25.00 Annual Drug Doctor All Your Drugs on $8,710 Enroll
Deductible: $0 Choice: Any Formulary: Yes 4 out of 5
Pharmacy Drug: Doctor stars
Status: $20.40 Health Plan Drug Restrictions:
Preferred Cost- Health: Deductible: $0 Out of Pocket Yes
Sharing $4.60 Drug Copay/ Spending Lower Your
Coinsurance: Limit: Drug Costs
Cost as of Part B $3 - $100, 33% $10,000 In
Today: $4,894 Premium and Out-of- MTM Program :
Reduction: network Yes
Mail Order No $6,700 In-
Cost as of network
Today: $7,435

HumanaChoice R0923-002 (Regional PPO) (R0923-002-0)
Organization: Humana
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Star
Costs: [?] [?] Copay [?] / Restrictions [?] Health and Rating: [?]
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $75.00 Annual Drug Doctor All Your Drugs on $9,620 Enroll
Deductible: $0 Choice: Any Formulary: Yes 3.5 out of 5
Pharmacy Drug: Doctor stars
Status: $21.90 Health Plan Drug Restrictions:
Preferred Cost- Health: Deductible: Out of Pocket Yes
Sharing $53.10 $500 annual Spending Lower Your
deductible Limit: Drug Costs
Cost as of Part B Drug Copay/ $10,000 In
Today: $4,909 Premium Coinsurance: and Out-of- MTM Program :
Reduction: $6 - $99, 33% network Yes
Mail Order No $6,700 In-
Cost as of network
Today: $7,450
Advantra Gold (HMO) (H3959-001-0)
Organization: Coventry Health Care
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Star
Costs: [?] [?] Copay [?] / Restrictions [?] Health and Rating: [?]
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $40.00 Annual Drug Doctor All Your Drugs on $8,570 Enroll
Deductible: $0 Choice: Plan Formulary: Yes 4.5 out of 5
Pharmacy Drug: Doctors for stars
Status: $37.00 Health Plan Most Services Drug Restrictions:
Preferred Cost- Health: Deductible: $0 Yes
Sharing $3.00 Drug Copay/ Out of Pocket Lower Your
Coinsurance: Spending Drug Costs
Cost as of Part B $0 - $100, 33% Limit: $4,900
Today: $5,057 Premium In-network MTM Program :
Reduction: Yes
Mail Order No
Cost as of
Today: $7,452
HumanaChoice H5216-119 (PPO) (H5216-119-0)
Organization: Humana
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Star
Costs: [?] [?] Copay [?] / Restrictions [?] Health and Rating: [?]
Coinsurance: and Other Drug
[?] Programs: Costs: [?]

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