Page 36 - Cover Letter and Evaluation for Amy Prack

Retail $28.00 Annual Drug Doctor All Your Drugs on $4,110 Enroll
Deductible: $170 Choice: Formulary: Yes 4 out of 5
Pharmacy Drug: $22.20 Plan stars
Status: Health: $5.80 Health Plan Doctors for Drug Restrictions:
Standard Deductible: $0 Most Yes
Cost-Sharing Part B Drug Copay/ Services Lower Your Drug
Premium Coinsurance: $2 - Costs
Cost as of Reduction: $95, 29% Out of
Today: $533 No Pocket MTM Program : Yes
Spending
Mail Order Limit:
Cost as of $4,500 In-
Today: $530 network

AARP MedicareComplete Plan 3 (HMO) (H5253-063-0)
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: [?] [?]
Retail $114.00 Annual Drug Doctor All Your Drugs on $4,840 4 out of 5 Enroll
Deductible: $0 Choice: Formulary: Yes
Pharmacy Drug: $26.00 Plan stars
Status: Health: Health Plan Doctors for Drug Restrictions:
Standard $88.00 Deductible: $0 Most Yes
Cost-Sharing Drug Copay/ Services Lower Your Drug
Part B Coinsurance: $0 - Costs
Cost as of Premium $95, 33% Out of
Today: $546 Reduction: Pocket MTM Program : Yes
No Spending
Mail Order Limit: This plan is
Cost as of $3,600 In-
Today: $557 network compared in your
evaluation.
HumanaChoice H5525-042 (PPO) (H5525-042-0)
Organization: Humana
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 $4,650 Enroll
Deductible: $250 Choice: Formulary: Yes 4 out of 5
Pharmacy Drug: $0.00 Any Doctor stars
Status: Health: $0.00 Health Plan Drug Restrictions:
Preferred Deductible: $0 Out of Yes
Cost-Sharing Part B Drug Copay/ Pocket Lower Your Drug
Premium Coinsurance: $7 - Spending Costs
Cost as of Reduction: $100, 28% Limit:
Today: $576 No $6,700 In MTM Program : Yes
and Out-of-
Mail Order network
Cost as of $6,700 In-
Today: $643 network

AARP MedicareComplete Plan 5 (HMO) (H5253-062-0)
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: [?] [?]