Page 18 - Cover Letter and Medicare Evaluation for Vic Bosiger

Your Prescription Drug Costs

These costs are for your prescription drugs and are based on the dosages and monthly quantities that
you use. These costs include premiums, deductible, and co-payments.

Pharmacy Information

Client's pharmacy: When you need a retail prescription filled or refilled, you will
usually get the lowest prices at one of your plan's preferred
CVS pharmacies. Some plans do not have preferred pharmacies.

Is CVS a preferred pharmacy in the following plans' networks

AARP Medicare Advantage Plan 1 (HMO- CVS is a standard pharmacy in this plan, as are Kroger,
POS) Walgreens, and Walmart
Optima Medicare Value Advantage HMO CVS is a standard pharmacy in this plan; Kroger, Walgreens
Plan and Walmart are preferred pharmacies

CVS is a preferred pharmacy in this plan, as are Kroger,
Humana Choice Advantage PPO Plan
Walgreens, and Walmart

Wellcare Value Script Prescription Drug CVS is a preferred pharmacy in this plan;
Plan
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Plans' est. annual costs for your Rx drugs at CVS

To enroll in a plan, call its toll-free AARP Medicare Advantage Optima Medicare Value
number and ask to be enrolled effective Plan 1 (HMO-POS) Advantage HMO Plan
January 1, 2022
(800) 555-5757 (844) 563-4201

Est. annual costs for retail refills $2,948 $2,973

Est. annual costs with mail-order refills NA NA

This plan's Medicare quality rating Ratings not released yet Ratings not released yet

Plans' est. annual costs for your Rx drugs at CVS
To enroll in a plan, call its toll-free Humana Choice Advantage Wellcare Value Script
number and ask to be enrolled effective PPO Plan Prescription Drug Plan
January 1, 2022 (800) 833-2364 (888) 293-5151

Est. annual costs for retail refills $3,115 $3,199

Est. annual costs with mail-order refills NA NA

This plan's Medicare quality rating Ratings not released yet Ratings not released yet

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