Page 74 - Cover letter and evaluation for Thomas Barr

10/14/2017 Your Plan Results

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Your Plan Results
Zip Code: 21012
Current Coverage: Original Medicare
Current Subsidy: No Extra Help [?]
Drug List ID: 0585196480
Your plan results are organized by plan type and are initially sorted by lowest Password Date: 10/14/2017
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
Compare Plans. The costs displayed are estimates; your actual costs may vary.

You are now viewing 2018 plan data. View 2017 plan data.

This is a list of the lowest-cost plan
Symbols for the one drug that you take.
Lowest-cost plans are listed first.
Nationwide 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 $5,310 Not Available
Annual: $1,433 Part B: Deductible: $183 Willing Doctor Includes $1,433
$134 for drug costs
Out of Pocket Spending
Limit: Not Applicable

Prescription Drug Plans

21 plans were found in 21012 based on your search criteria. View 10 View 20 View All

Sort Results By
EnvisionRxPlus (PDP) (S7694-005-0)
Organization: EnvisionRx Plus
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $12.60 Annual Drug Deductible: All Your Drugs on Enrollment begins
$300 Formulary :Yes October 15, 2017
Pharmacy Status: 3 out of 5 stars
Preferred Cost- Drug Copay/ Coinsurance: Drug Restrictions: No
Sharing $1 - $29, 27% - 39% Lower Your Drug Costs
Annual: $163 MTM Program : Yes
Mail Order
Annual: $151
Aetna Medicare Rx Select (PDP) (S5810-279-0)
Organization: Aetna Medicare

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