Page 12 - Cover Letter and Evaluation for Amy Prack

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

When you need a retail prescription filled or refilled, you will
Giant Eagle
usually get the lowest prices at one of your plan's preferred
pharmacies. Some plans, though, do not have preferred
Monthly refills pharmacies.

Is Giant Eagle a preferred pharmacy in these plans' networks? Are there others nearby?

Aetna Medicare Rx Select Prescription Yes No
Drug Plan

Humana Gold Plus HMO Plan Yes CVS, Tremont, and Walgreens
(H6622-103)
AARP Medicare Complete Plan 2 This plan does not have
(an HMO) preferred pharmacies NA

Humana Choice PPO Plan Yes CVS, Tremont, and Walgreens
(H5525-042)
y g
Each plan's est. annual costs for your Rx drugs

If you get a Medigap policy, you will also Aetna Medicare Rx Select Humana Gold Plus HMO Plan
need to enroll in a stand-alone drug Prescription Drug Plan (H6622-103)
plan. To enroll, call the plan's toll-free (this plan is for people who have
number Medigap policies) (800) 833-2364
Est. annual costs for mail-order refills $1,179 $524

Est. annual costs for monthly refills $1,171 $640

This plan's Medicare quality rating 3 out of 5 stars 4 out of 5 stars

Each plan's est. annual costs for your Rx drugs

AARP Medicare Complete Plan
The Advantage plans compared in your 2 (an HMO)
Humana Choice PPO Plan
evaluation include Rx drug coverage (H5525-042)
(H5253-053)
Call plans' toll-free numbers to enroll (800) 555-5757 (800) 833-2364

Est. annual costs for mail-order refills $767 $774

Est. annual costs for monthly refills $914 $843

This plan's Medicare quality rating 4 out of 5 stars 4 out of 5 stars

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