Page 12 - Cover Letter and Medicare evaluation for Mr. Rod Fallow
P. 12
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?
SilverScript SmartRx Prescription Yes
Drug Plan
No. Neither are Walgreens or Walmart pharmacies. This plan
Ava Advantage HMO Plan
may not have preferred pharmacies.
UHC Medicare Advantage Assure No. Neither are Walgreens and Walmart pharmacies. This plan
HMO Plan may not have preferred pharmacies.
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The lowest-cost Part D stand-alone plan for your drugs
SilverScript SmartRx
Prescription Drug Plan
To enroll in a plan, call its toll-free
number (833) 526-2445
Est. annual costs for monthly refills $101
at CVS
Est. annual costs for mail-order refills $96
This plan's Medicare quality rating 3.5 out of 5 stars
Medicare Advantage plans' costs for your drugs
These two Medicare Advantage UHC Medicare Advantage
plans include prescription drug and Ava Advantage HMO Plan Assure HMO Plan
medical coverage (888) 979-2247 (800) 555-5757
Est. annual costs for monthly refills $27 $376
at CVS
Est. annual costs for mail-order refills $0 $366
This plan's Medicare quality rating 4 out of 5 stars 4 out of 5 stars
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