Page 12 - Cover Letter and Evaluation for Judy Thomas

Your Prescription Drug Costs

These costs are for your prescription drugs and are based on the dosages and monthly quantities that
you use. For the SilverScript Choice and the Aetna Medicare Rx Saver Plan, these costs include
premiums, deductibles, and co-payments.

Pharmacy Information

When you need a retail prescription filled or refilled, you will
Mail-order & monthly
usually get the lowest prices at one of your plan's preferred
pharmacies. Some plans, though, do not have preferred
King Soopers
pharmacies.
Is King Soopers a preferred pharmacy in the following plans' networks
SilverScript Choice Prescription Drug No. CVS is a preferred pharmacy in this plan
Plan

Aetna Medicare Rx Saver Prescription No. CVS and Costco are among this plan's preferred
Drug Plan pharmacies

PERA Anthem Medicare Advantage Plan This plan does not list any preferred pharmacies
#1

PERA Anthem Medicare Advantage Plan This plan does not list any preferred pharmacies
#2
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The two lowest-cost Part D stand-alone plans for your drugs

SilverScript Choice Aetna Medicare Rx Saver
Prescription Drug Plan Prescription Drug Plan
To enroll in a plan, call its toll-free
number (866) 552-6106 (833) 859-6031
Est. annual costs for monthly refills at a
CVS Pharmacy $1,473 $1,523

Est. annual costs with mail-order refills $1,339 $1,483

This plan's Medicare quality rating 3.5 out of 5 stars 3 out of 5 stars
PERA plans' costs for your drugs

Costs are the same in both plans. PERA Anthem Medicare PERA Anthem Medicare
Premiums not included Advantage Plan #1 Advantage Plan #2

Est. annual costs with monthly refills $1,080 $1,080

Est. annual costs with mail-order refills $720 $720

This plan's Medicare quality rating NA NA

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