Page 35 - Cover Letter and Evaluation for Amy Prack

This plan is
Humana Gold Plus H6622-013 (HMO) (H6622-013-0) compared in your
Organization: Humana evaluation.
Estimated Monthly Deductibles [?] Health Drug Coverage [?] Estimated Overall
Annual Drug Premium: and Drug Copay Benefits: , Drug Restrictions Annual Health Star
Costs: [?] [?] [?] / Coinsurance: [?] [?] and Other and Drug Rating:
[?] Programs: Costs: [?] [?]
Retail $0.00 Annual Drug Doctor All Your Drugs on $3,950 Enroll
Deductible: $0 Choice: Formulary: Yes 4 out of 5
Pharmacy Drug: $0.00 Plan stars
Status: Health: $0.00 Health Plan Doctors for Drug Restrictions:
Preferred Deductible: $0 Most Yes
Cost-Sharing Part B Drug Copay/ Services Lower Your Drug
Premium Coinsurance: $7 - Costs
Cost as of Reduction: $100, 33% Out of
Today: $373 No Pocket MTM Program : Yes
Spending
Mail Order Limit: These are the costs
Cost as of $4,500 In-
Today: $393 network for your Rx drugs for
the last 7 months of
MedMutual Advantage Classic (HMO) (H6723-001-1) this year.
Organization: Medical Mutual of Ohio
Estimated Monthly Deductibles [?] Health Drug Coverage [?] Estimated Overall
Annual Drug Premium: and Drug Copay Benefits: , Drug Restrictions Annual Health Star
Costs: [?] [?] [?] / Coinsurance: [?] [?] and Other and Drug Rating:
[?] Programs: Costs: [?] [?]
Retail $0.00 Annual Drug Doctor All Your Drugs on $3,890 3.5 out of Enroll
Deductible: $160 Choice: Formulary: Yes
Pharmacy Drug: $0.00 Plan 5 stars
Status: Health: $0.00 Health Plan Doctors for Drug Restrictions:
Preferred Deductible: $0 Most Yes
Cost-Sharing Part B Drug Copay/ Services Lower Your Drug
Premium Coinsurance: $0 - Costs
Cost as of Reduction: $42, 30% - 50% Out of
Today: $412 No Pocket MTM Program : Yes
Spending
Mail Order Limit:
Cost as of $4,300 In-
Today: $490 network

MedMutual Advantage Plus (HMO) (H6723-003-1)
Organization: Medical Mutual of Ohio
Estimated Monthly Deductibles [?] Health Drug Coverage [?] Estimated Overall
Annual Drug Premium: and Drug Copay Benefits: , Drug Restrictions Annual Health Star
Costs: [?] [?] [?] / Coinsurance: [?] [?] and Other and Drug Rating:
[?] Programs: Costs: [?] [?]
Retail $99.00 Annual Drug Doctor All Your Drugs on $4,750 Enroll
Deductible: $55 Choice: Formulary: Yes 3.5 out of
Pharmacy Drug: $13.30 Plan 5 stars
Status: Health: Health Plan Doctors for Drug Restrictions:
Preferred $85.70 Deductible: $0 Most Yes
Cost-Sharing Drug Copay/ Services Lower Your Drug
Part B Coinsurance: $0 - Costs
Cost as of Premium $42, 32% - 50% Out of
Today: $442 Reduction: Pocket MTM Program : Yes
No Spending
Mail Order Limit:
Cost as of $3,400 In-
Today: $478 network This plan is
compared in your
AARP MedicareComplete Plan 2 (HMO) (H5253-053-0) evaluation.
Organization: UnitedHealthcare
Estimated Monthly Deductibles [?] Health Drug Coverage [?] Estimated Overall
Annual Drug Premium: and Drug Copay Benefits: , Drug Restrictions Annual Health Star
Costs: [?] [?] [?] / Coinsurance: [?] [?] and Other and Drug Rating:
[?] Programs: Costs: [?] [?]