Page 88 - Cover letter and evaluation for Michele Buros

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Retail $27.40 Annual Drug Doctor Choice: All Your Drugs on $3,940 Enroll
Deductible: Any Doctor Formulary :Yes
Pharmacy Drug: $27.40 $325 4 out of 5
Status: Health: $0.00 Out of Pocket Drug Restrictions: stars
Preferred Cost- Health Plan Spending Limit: Yes
Sharing Part B Deductible: $10,000 In and Lower Your Drug
Premium $183 annual Out-of-network Costs
Cost as of Today: Reduction deductible $6,700 In-
$274 :No Drug Copay/ network MTM Program :
Coinsurance: Yes
Mail Order $0 - $100,
Cost as of Today: 26%
$274
Aetna Medicare Gold Plan (PPO) (H5521-122-0)
Organization: Aetna Medicare
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall Star
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Rating: [?]
Costs: [?] [?] Copay [?] / Restrictions [?] Health and
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $156.00 Annual Drug Doctor Choice: All Your Drugs on $4,980 Enroll
Deductible: $0 Any Doctor Formulary :Yes
Pharmacy Drug: $25.10 4 out of 5
Status: Health: Health Plan Out of Pocket Drug Restrictions: stars
Preferred Cost- $130.90 Deductible: Spending Limit: Yes
Sharing $500 annual $7,500 In and Lower Your Drug
Part B deductible Out-of-network Costs
Cost as of Today: Premium Drug Copay/ $4,500 In-
$278 Reduction Coinsurance: network MTM Program :
:No $2 - $100, Yes
Mail Order 33%
Cost as of Today:
$251
Advantra Gold (HMO) (H3959-001-0)
Organization: HealthAmerica Pennsylvania
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall Star
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Rating: [?]
Costs: [?] [?] Copay [?] / Restrictions [?] Health and
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $86.00 Annual Drug Doctor Choice: All Your Drugs on $4,030 Enroll
Deductible: $0 Plan Doctors Formulary :Yes
Pharmacy Drug: $29.10 for Most 4 out of 5
Status: Health: Health Plan Services Drug Restrictions: stars
Preferred Cost- $56.90 Deductible: $0 Yes
Sharing Drug Copay/ Out of Pocket Lower Your Drug
Part B Coinsurance: Spending Limit: Costs
Cost as of Today: Premium $0 - $100, $6,700 In-
$291 Reduction 33% network MTM Program :
:No Yes
Mail Order
Cost as of Today:
$291
HumanaChoice H5216-119 (PPO) (H5216-119-0)
Organization: Humana Insurance Company
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall Star
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Rating: [?]
Costs: [?] [?] Copay [?] / Restrictions [?] Health and
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $123.00 Annual Drug Doctor Choice: All Your Drugs on $4,290 Enroll
Deductible: $0 Any Doctor Formulary :Yes
Pharmacy Drug: $24.10 4 out of 5
Status: Health: Health Plan Out of Pocket Drug Restrictions: stars
Preferred Cost- $98.90 Deductible: $0 Spending Limit: Yes
Sharing Drug Copay/ $10,000 In and Lower Your Drug
Part B Coinsurance: Out-of-network Costs
Cost as of Today: Premium $5 - $97, 33% $6,700 In-
$307 Reduction network MTM Program :
:No Yes
Mail Order
Cost as of Today:
$241
AARP MedicareComplete Plan 2 (HMO) (H1944-011-0)
Organization: UnitedHealthcare

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