Page 19 - Cover Letter and Evaluation for Patricia Hendrickson
P. 19
Plans that appear to meet your criteria (cont'd)
Horizon Blue
CIGNA Medicare
Plan name Medigap Plan F Medicare Supplemental Plan Aetna Medicare
Advantage Plan
Advantage HMO
Toll-Free Number NA (888) 328-4542 NA NA
Estimated annual premiums for medical coverage
lity ratings from Medicare web site (best rating = 5 stars)
2018 standard Part B
premium of $134 a $1,608 $1,608 $1,608
month*
Health plan annual This plan is being
discontinued
premiums (Medigap $2,125 $0 $1,039
premiums are estimates)
Total $3,733 $1,608 $2,647
Minimum costs for Medicare-covered services
Total medical premiums
(from above) $3,733 $1,608 $2,647
Plan health deductible
(includes Part B deductible if $0 $0 $100
not covered by plan**)
Annual Rx costs, mail-
order (premiums, $240 $56 $120
deductibles, co-pays)
Total Minimum Costs
(includes cost-sharing for the $3,973 $1,664 $2,867
Rx drugs you now take)
Cost-sharing for doctors office visits
=
In-Network Primary
Care Co-Pays $10 20% of cost until
No co-pays for
In-Network Specialist Medicare-covered plan's $750 out-of-
Co-Pays services $25 pocket limit is
Out-of-Network reached
Co-Pays No coverage
*This is 2018 Part B premium for new enrollees. Higher income people may pay more.
**Part B deductible in 2018 is $183.
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