Page 81 - Evaluation with Cover Letter for Henry Rose

9/16/2017 Your Plan Results
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $22.40 Annual Drug Deductible: All Your Drugs on Enroll
$400 Formulary :Yes
Pharmacy Status: 2.5 out of 5 stars
Out-of-network Drug Copay/ Coinsurance: Drug Restrictions: Yes
$0 - $27, 25% - 32%
Lower Your Drug Costs
Cost as of Today:
$1,064 MTM Program : Yes
Mail Order
Cost as of Today:
$85
Aetna Medicare Rx Saver (PDP) (S5810-041-0)
Organization: Aetna Medicare
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $31.90 Annual Drug Deductible: All Your Drugs on Enroll
$360 Formulary :Yes
Pharmacy Status: 3.5 out of 5 stars
Preferred Cost- Drug Copay/ Coinsurance: Drug Restrictions: No
Sharing $1 - $30, 25% - 35% Lower Your Drug Costs
Cost as of Today: MTM Program : Yes
$108
Mail Order
Cost as of Today:
$108
Magellan Rx Medicare Basic (PDP) (S4607-009-0)
Organization: Magellan Rx Medicare
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $32.20 Annual Drug Deductible: All Your Drugs on Plan too new to Enroll
$400 Formulary :Yes be measured
Pharmacy Status:
Standard Cost- Drug Copay/ Coinsurance: Drug Restrictions: No
Sharing $1 - $47, 25% - 50% Lower Your Drug Costs
Cost as of Today: MTM Program : Yes
$135
Mail Order
Cost as of Today:
$126
WellCare Classic (PDP) (S4802-069-0)
Organization: WellCare
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $27.20 Annual Drug Deductible: All Your Drugs on Enroll
$400 Formulary :Yes
Pharmacy Status: 2.5 out of 5 stars
Standard Cost- Drug Copay/ Coinsurance: Drug Restrictions: No
Sharing $0 - $47, 25% - 50% Lower Your Drug Costs
Cost as of Today: MTM Program : Yes
$185
Mail Order
Cost as of Today:
$141
First Health Part D Value Plus (PDP) (S5768-130-0)
Organization: First Health Part D
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:

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