Page 11 - Cover Letter and Evaluation for Diann Weade
P. 11
Plans that appear to meet your criteria (cont'd)
Your current plan Humana Gold Plus
Plan name Medigap Plan G Medigap Plan N Anthem MediBlue Plan (HMO)
Plus (HMO) H5619-051
Toll-Free Number NA NA (855) 251-8827 (800) 833-2364
Estimated annual premiums for medical coverage
lity ratings from Medicare web site (best rating = 5 stars)
2019 standard Part B
premium of $135.50 a $1,626 $1,626 $1,626 $1,626
month*
Health plan annual
premiums (Medigap $1,300 $1,150 $0 $0
premiums are estimates)
Total $2,926 $2,776 $1,626 $1,626
Minimum costs for Medicare-covered services
Total medical premiums $2,926 $2,776 $1,626 $1,626
(from above)
Plan health deductible
(includes Part B deductible if $185 $185 $0 $0
not covered by plan**)
Rx costs, monthly refills
at CVS (premiums, $826 $826 $760 $496
deductibles, co-pays)
Total Minimum Costs
(includes cost-sharing for the $3,937 $3,787 $2,386 $2,122
Rx drugs you now take)
Cost-sharing for doctors office visits
=
In-Network Primary
Care Co-Pays $5 $0
No co-pays for You pay 5% of
In-Network Specialist Medicare-covered Medicare approved
Co-Pays services amount $40 $40
Out-of-Network
Co-Pays Not covered Not covered
*This is 2019 standard Part B premium for new enrollees who are not yet receiving Social Security benefits.
**Part B deductible in 2019 is $185.
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