Page 49 - Evaluation for 2018

12/23/2017 Your Plan Results
AARP MedicareComplete Plan 2 (HMO) (H1286-009-0)
Organization: UnitedHealthcare
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall Star
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Rating: [?]
Costs: [?] [?] Copay [?] / Restrictions [?] Health and
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $55.00 Annual Drug Doctor Choice: All Your Drugs on $3,830 Enroll
Deductible: Plan Doctors Formulary :Yes
Pharmacy Drug: $40.40 $180 for Most 4 out of 5
Status: Health: Services Drug Restrictions: stars
Standard Cost- $14.60 Health Plan Yes
Sharing Deductible: $0 Out of Pocket Lower Your Drug
Part B Drug Copay/ Spending Costs
Annual: Premium Coinsurance: $2 Limit: $4,200
Reduction - $95, 29% In-network MTM Program :
Mail Order :No Yes
Annual: $485
Community HealthFirst MA Extra Plan (HMO) (H5826-010-0)
Organization: Community HealthFirst Medicare Advantage Plan
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall Star
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Rating: [?]
Costs: [?] [?] Copay [?] / Restrictions [?] Health and
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $20.90 Annual Drug Doctor Choice: All Your Drugs on $4,280 Enroll
Deductible: $0 Plan Doctors Formulary :Yes
Pharmacy Drug: $20.90 for Most 3.5 out of 5
Status: Health: Health Plan Services Drug Restrictions: stars
Standard Cost- $0.00 Deductible: $0 Yes
Sharing Drug Copay/ Out of Pocket Lower Your Drug
Part B Coinsurance: $2 Spending Costs
Annual: Premium - $47, 25% - Limit: $6,700
Reduction 33% In-network MTM Program :
Mail Order :No Yes
Annual: $491
Allwell Medicare Plus (HMO) (H0029-006-0)
Organization: Allwell
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall Star
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Rating: [?]
Costs: [?] [?] Copay [?] / Restrictions [?] Health and
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $34.50 Annual Drug Doctor Choice: All Your Drugs on $4,390 Plan too new Enroll
Deductible: Plan Doctors Formulary :Yes to be
Pharmacy Drug: $34.50 $405 for Most measured
Status: Health: Services Drug Restrictions:
Standard Cost- $0.00 Health Plan Yes
Sharing Deductible: Out of Pocket Lower Your Drug
Part B $183 per year Spending Costs
Annual: Premium for in-network Limit: $6,700
Reduction services. In-network MTM Program :
Mail Order :No Drug Copay/ Yes
Annual: $855 Coinsurance:
25%
Community HealthFirst MA Pharmacy Plan (HMO) (H5826-008-0)
Organization: Community HealthFirst Medicare Advantage Plan
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall Star
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Rating: [?]
Costs: [?] [?] Copay [?] / Restrictions [?] Health and
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $67.00 Annual Drug Doctor Choice: All Your Drugs on $4,440 Enroll
Deductible: $0 Plan Doctors Formulary :Yes
Pharmacy Drug: $51.60 for Most 3.5 out of 5
Status: Health: Health Plan Services Drug Restrictions: stars
Standard Cost- $15.40 Deductible: $0 Yes
Sharing Drug Copay/ Out of Pocket Lower Your Drug
Part B Coinsurance: $2 Spending Costs
Annual: Premium - $47, 25% - Limit: $6,700
Reduction 33% In-network MTM Program :
Mail Order :No Yes
Annual: $859

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