Page 76 - Evaluation for 2018
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12/23/2017                                             Your Plan Results







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         Your Plan Results
                                                                          Zip Code:  99005
                                                                          Current Coverage:  Original Medicare
                                                                          Current Subsidy: No Extra Help [?]
                                                                          Drug List ID:  1321108544
         Your plan results are organized by plan type and are initially sorted by lowest  Password Date:  12/23/2017
         estimated cost. To view more plans, select View 20 or View All. Select any plan  Important Coverage Information
         name for details. Compare up to 3 plans by using the checkboxes and selecting This is a list of the 15 Medicare
         Compare Plans. The costs displayed are estimates; your actual costs may vary. Advantage plans available in your zip
                                                                   code that include Rx drug coverage. This
         You are now viewing 2018 plan data.  View 2017 plan data.
                                                                   list is sorted by the plans' costs for your
                                                                   Rx drugs if you get mail-order refills, with
              Symbols                                              the lowest-cost plans listed first.


               Some Dental Coverage   Some Vision Coverage   Nationwide Coverage   Some Hearing Coverage


                Your Current Plan(s)
               Original Medicare (H0001-001-0)
               Includes Part A (Hospital Insurance) and/or Part B (Medical Insurance) - Excludes Part D Drug
               Coverage
           Estimated      Monthly   Deductibles:  Health Benefits: [?]  Drug Coverage [?]  Estimated  Overall Star
           Annual Drug    Premium:  [?] and Drug                   , Drug Restrictions  Annual Health  Rating: [?]
           Costs: [?]     [?]       Copay [?] /                    [?]              and Drug Costs:
                                    Coinsurance:                                    [?]
                                    [?]
           Retail         Standard  Part B       Doctor Choice: Any  N/A            $6,170        Not Available
           Annual:        Part B:   Deductible: $183  Willing Doctor                Includes $2,279
                          $134                                                      for drug costs
                                                 Out of Pocket Spending
                                                 Limit: Not Applicable



                Medicare Health Plans with Drug Coverage

          15 plans were found in 99005 based on your search criteria.  View 10 View 15



            Sort Results by
               Humana Gold Plus H5619-102 (HMO) (H5619-102-0)
               Organization: Arcadian Health Plan, Inc.
           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        $33.00     Annual Drug  Doctor Choice:  All Your Drugs on  $3,920         Enroll
                                    Deductible:  Plan Doctors  Formulary  :Yes
           Pharmacy      Drug: $0.00  $150       for Most                              4 out of 5
           Status:       Health:                 Services    Drug Restrictions:        stars
           Preferred Cost-  $33.00  Health Plan              Yes
           Sharing                  Deductible: $0   Out of Pocket  Lower Your Drug
                         Part B     Drug Copay/  Spending    Costs
           Annual:       Premium    Coinsurance: $4  Limit: $5,000
                         Reduction  - $100, 30%  In-network   MTM Program  :
           Mail Order    :No                                 Yes
           Annual: $0


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