Page 114 - Appendices for Patricia Stelter PDF Version
P. 114

XYi/WX  /[jk|NaP bcba`L } c  l    ~   
    /0  @AB C‚LMN NML OP\m
      345K
             	
 	 
         
     	       /0 1   2 @AB CDEFGHGIJHFPc/YRZ[R lS-Un__o^pq\mn__o^pq Y [lUZrWY\sso^__tcLM   uvMNwM`fQ xdL wMLcb LgLM  bNaP y uNcw aw `gdLLM  bNaP y uNcw aw `gdL
      ~ 4??€7<4 = >?76K

                 ! "#  $ %" &'(! )*+ ,-	    -  	
  -. 67 849:;7<4 = >?76LMN NML OPQRSTUVWX  /YRZ[R\]^_ O` abcdQ eO f bNaP `ghcNM  \mzM  {gNbcN uvMNwM`fQ xdL wMLcb Lg1   2FJHG‚EHFQRSTUVWX  /YRZ[R\ s^]_ O` abcdQ eO f bNaP `ghcNMPcYRZ[R lS-Un_ƒƒ^mqtcLM   uvMNwM`fQ xdL wMLcb LgLM  bNaP y uNcw aw `gdL

      XYi/WX  /[jk  /
                                                            These stand-alone drug plans are sorted by
                                                            their costs for Tirosint -- even though none of
                                                            the lowest-cost plans cover Tirosint, you can
                                                            still get this drug through the plan, but you will
                                                            likely pay more than if you get it through the
                                                            plan. There is no benefit to getting it through
                                                            the plan if it is not covered, and any Tirosint
                                                            purchases will not count toward the plan's

                                                            deductible and other coverage phases.







                                                                 This is a new plan
                                                                 beginning January,
                                                                 2021.
   109   110   111   112   113   114   115   116   117   118   119