Page 80 - Cover Letter and evaluation for Paul J. Lingane

9/14/2017 Your Plan Results
Retail $33.40 Annual Drug Deductible: All Your Drugs on Enroll
Annual: $400 Formulary :N/A
3 out of 5 stars
Mail Order Drug Copay/ Coinsurance: Drug Restrictions: N/A
Annual: N/A $1 - $21, 25% - 30%
MTM Program : Yes

WellCare Classic (PDP) (S4802-094-0)
Organization: WellCare
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $34.90 Annual Drug Deductible: All Your Drugs on Enroll
Annual: $400 Formulary :N/A
2.5 out of 5 stars
Mail Order Drug Copay/ Coinsurance: Drug Restrictions: N/A
Annual: N/A $0 - $46, 25% - 48%
MTM Program : Yes

First Health Part D Value Plus (PDP) (S5768-155-0)
Organization: First Health Part D
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $42.30 Annual Drug Deductible: $0 All Your Drugs on Enroll
Annual: Formulary :N/A
Drug Copay/ Coinsurance: 3.5 out of 5 stars
Mail Order $2 - $47, 33% - 50% Drug Restrictions: N/A
Annual: N/A
MTM Program : Yes

Cigna-HealthSpring Rx Secure-Extra (PDP) (S5617-277-0)
Organization: Cigna-HealthSpring Rx
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $46.60 Annual Drug Deductible: $50 All Your Drugs on Enroll
Annual: Formulary :N/A
Drug Copay/ Coinsurance: 3 out of 5 stars
Mail Order $5 - $42, 32% - 50% Drug Restrictions: N/A
Annual: N/A
MTM Program : Yes

Notes:
Your costs may be different depending on your Part B premium, any Part D penalty that may apply, and whether you qualify for
Extra Help from Medicare paying your drug costs.

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