Page 82 - Cover Letter and evaluation for Paul J. Lingane

9/15/2017 Your Medicare Health Plan Details

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Your Plan Details
Zip Code: 94062
Current Coverage: Original Medicare
Current Subsidy: No Extra Help [?]
Select the tabs below for more detailed information about the plan health benefits,
drug costs and more coverage and star ratings. Important Coverage Information

Symbols
Nationwide Coverage This is the benefit summary for
the Humana-Walmart Rx Plan.
* Estimated

Humana Walmart Rx Plan 500 West Main Street Overall Star Rating: [?] Enroll
Louisville, KY 40202
(PDP)
(S5884-178-0) Members: 3 out of 5 stars
1-800-281-6918 Call this number to
Organization: Humana Insurance 711 (TTY/TDD) enroll.
Company
Non Members:
Plan Type: 1-800-706-0872
711 (TTY/TDD)

NOTE: Health Plan Benefits are based on Original Medicare
Fixed Costs

Monthly Health Plan Premium: Not Applicable
Monthly Drug Plan Premium: $17.00

Estimated Costs

You have not entered any drugs. The estimate below includes only the cost of the monthly premiums that you would pay for the
plan. To get specific costs for the drugs you take, Enter drugs.
Estimated annual drug costs: [?] $204.00

This does not include any health costs you may have.
Medicare costs at a glance

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