Page 9 - Cover Letter and Medicare Evaluation for Diane Falten
P. 9
Plans that appear to meet your criteria (cont'd)
Martin's Point Martin's Point
Plan name Generations Advantage Humana Choice Generations Advantage
Prime (HMO-POS) Plan Advantage PPO Plan Flex Regional PPO Plan
Toll-Free Number (888) 640-4423 (800) 833-2364 (888) 640-4423
Estimated medical premiums
lity ratings from Medicare web site (best rating = 5 stars)
(2022 Part B premiums & Part B deductible not available yet)
2021 Standard Part B
$1,782 $1,782 $1,782
premium *
Health plan premiums
(Medigap premiums are $0 $0 $421
estimates)
Total $1,782 $1,782 $2,203
Minimum costs for Medicare-covered services
Total medical premiums $1,782 $1,782 $2,203
(from above)
Plan health deductible
(includes Part B deductible $0 $0 $0
if not covered by plan**)
Est. annual Rx costs at
CVS (premiums, $120 $226 $473
deductibles, co-pays)
Total Minimum Costs
(includes cost-sharing for $1,902 $2,008 $2,676
the Rx drugs you now take)
Cost-sharing for doctors office visits
=
In-Network Primary
Care Co-Pays $0 $0 $0
In-Network Specialist
Co-Pays $40 $45 $50
Out-of-Network
$35 Primary Care; $55
Co-Pays specialist 30% of cost 30% of cost
*The standard Part B premium for new enrollees in 2021 is $148.50 a month; higher income people may pay
more. **Part B deductible in 2021 is $203.
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