Page 65 - Cover Letter & Evaluation for Michael Novotny

6/9/2018 Your Plan Results
Health Net Healthy Heart (HMO) (H0562-100-1)
Organization: Health Net of California
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 $17.00 Annual Drug Doctor All Your Drugs on $2,950 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 $17.00 Deductible: $0 Out of Pocket N/A
Drug Copay/
Part B Coinsurance: Spending MTM Program :
Premium $0 - $90, 33% Limit: $2,400 Yes
Reduction In-network
:No

AARP MedicareComplete SecureHorizons Plan 3 (HMO) (H0543-
153-0)
Organization: UnitedHealthcare
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 $17.30 Annual Drug Doctor All Your Drugs on $3,590 Enroll
Annual: Deductible: Choice: Plan Formulary :N/A
$207.60 Drug: $405 Doctors for 4.5 out of 5
$17.30 Most Services Drug Restrictions: stars
Mail Order Health: Health Plan N/A
Annual: N/A $0.00 Deductible: $0 Out of Pocket
Drug Copay/ Spending MTM Program :
Part B Coinsurance: Limit: $6,700 Yes
Premium 25% In-network
Reduction
:No
Easy Choice Plus Plan (HMO) (H5087-002-0)
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 $25.70 Annual Drug Doctor All Your Drugs on $3,460 Enroll
Annual: Deductible: Choice: Plan Formulary :N/A
$308.40 Drug: $405 Doctors for 3.5 out of 5
$25.70 Most Services Drug Restrictions: stars
Mail Order Health: Health Plan N/A
Annual: N/A $0.00 Deductible: $0 Out of Pocket
Spending
Drug Copay/ MTM Program :
Part B Coinsurance: Limit: $6,700 Yes
Premium $0 - $99, 25% In-network
Reduction
:No
AARP MedicareComplete SecureHorizons Premier (HMO) (H0543-
165-0)
Organization: UnitedHealthcare
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: [?]

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