Page 89 - Cover letter and evaluation for Michele Buros

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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 $44.00 Annual Drug Doctor Choice: All Your Drugs on $3,950 Enroll
Deductible: $0 Plan Doctors Formulary :Yes
Pharmacy Drug: $26.50 for Most 4.5 out of 5
Status: Health: Health Plan Services Drug Restrictions: stars
Standard Cost- $17.50 Deductible: $0 Yes
Sharing Drug Copay/ Out of Pocket Lower Your Drug
Part B Coinsurance: Spending Limit: Costs
Cost as of Today: Premium $3 - $95, 33% $5,900 In-
$314 Reduction network MTM Program :
:No Yes
Mail Order
Cost as of Today:
$265
HumanaChoice H5525-017 (PPO) (H5525-017-0)
Organization: Humana Benefit Plan of Illinois, Inc.
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 $50.00 Annual Drug Doctor Choice: All Your Drugs on $4,060 Enroll
Deductible: $0 Any Doctor Formulary :Yes
Pharmacy Drug: $26.10 4 out of 5
Status: Health: Health Plan Out of Pocket Drug Restrictions: stars
Preferred Cost- $23.90 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 $7 - $100, $6,700 In-
$338 Reduction 33% network MTM Program :
:No Yes
Mail Order
Cost as of Today:
$261
Advantra Gold (PPO) (H5522-001-0)
Organization: HealthAmerica
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 $116.00 Annual Drug Doctor Choice: All Your Drugs on $4,550 Enroll
Deductible: $0 Any Doctor Formulary :Yes
Pharmacy Drug: $34.50 4 out of 5
Status: Health: Health Plan Out of Pocket Drug Restrictions: stars
Preferred Cost- $81.50 Deductible: Spending Limit: Yes
Sharing $750 annual $10,000 In and Lower Your Drug
Part B deductible Out-of-network Costs
Cost as of Today: Premium Drug Copay/ $6,700 In-
$345 Reduction Coinsurance: network MTM Program :
:No $0 - $100, Yes
Mail Order 33%
Cost as of Today:
$345
AARP MedicareComplete Plan 3 (HMO) (H1944-025-0)
Organization: UnitedHealthcare
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: [?]

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