Page 63 - Cover Letter & Evaluation for Michael Novotny

6/9/2018 Your Plan Results
Inter Valley Health Plan Service To Seniors (HMO) (H0545-001-0)
Organization: Inter Valley Health Plan
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Star
Costs: [?] [?] Copay [?] / Restrictions [?] Health and Rating: [?]
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $0.00 Annual Drug Doctor All Your Drugs on $2,040 Enroll
Annual: $0.00 Deductible: $0 Choice: Plan Formulary :N/A
Drug: $0.00 Doctors for 3.5 out of 5
Mail Order Health: Health Plan Most Services Drug Restrictions: stars
Annual: N/A $0.00 Deductible: $0 Out of Pocket N/A
Drug Copay/
Part B Coinsurance: Spending MTM Program :
Premium $0 - $47, 25% Limit: $2,000 Yes
Reduction - 33% In-network
:No

Easy Choice Best Plan (HMO) (H5087-005-0)
Organization: Easy Choice Health Plan
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Star
Costs: [?] [?] Copay [?] / Restrictions [?] Health and Rating: [?]
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $0.00 Annual Drug Doctor All Your Drugs on $2,110 Enroll
Annual: $0.00 Deductible: $0 Choice: Plan Formulary :N/A
Drug: $0.00 Doctors for 3.5 out of 5
Mail Order Health: Health Plan Most Services Drug Restrictions: stars
Annual: N/A $0.00 Deductible: $0 Out of Pocket N/A
Drug Copay/
Part B Coinsurance: Spending MTM Program :
Premium $0 - $99, 33% Limit: $3,400 Yes
Reduction In-network
:No

Care1st AdvantageOptimum Plan (HMO) (H5928-004-0)
Organization: Care1st Health Plan
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Star
Costs: [?] [?] Copay [?] / Restrictions [?] Health and Rating: [?]
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $0.00 Annual Drug Doctor All Your Drugs on $1,970 Enroll
Annual: $0.00 Deductible: $0 Choice: Plan Formulary :N/A
Drug: $0.00 Doctors for 3.5 out of 5
Mail Order Health: Health Plan Most Services Drug Restrictions: stars
Annual: N/A $0.00 Deductible: $0 Out of Pocket N/A
Drug Copay/
Part B Coinsurance: Spending MTM Program :
Premium $0 - $80, 33% Limit: $2,400 Yes
Reduction In-network
:No

Brand New Day Classic Care Drug Savings (HMO) (H0838-025-0)
Organization: Brand New Day
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Star
Costs: [?] [?] Copay [?] / Restrictions [?] Health and Rating: [?]
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $0.00 Annual Drug Doctor All Your Drugs on $2,080 Enroll
Annual: $0.00 Deductible: $0 Choice: Plan Formulary :N/A
Drug: $0.00 Doctors for 3.5 out of 5
Mail Order Health: Health Plan Most Services Drug Restrictions: stars
Annual: N/A $0.00 Deductible: $0 Out of Pocket N/A
Drug Copay/
Part B Coinsurance: Spending MTM Program :
Premium $0 - $75, 33% Limit: $3,400 Yes
Reduction In-network
:No

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