Page 41 - Cover Letter and Evaluation for Amy Prack

Retail $0.00 Annual Drug Doctor All Your Drugs on $4,800 Enroll
Deductible: $95 Choice: Formulary: Yes 4 out of 5
Pharmacy Drug: $0.00 Any Doctor stars
Status: Health: $0.00 Health Plan Drug Restrictions:
Preferred Deductible: $1,500 Out of Yes
Cost-Sharing Part B annual deductible Pocket Lower Your Drug
Premium Drug Copay/ Spending Costs
Cost as of Reduction: Coinsurance: $2 - Limit:
Today: $782 No $100, 31% $10,000 In MTM Program : Yes
and Out-of-
Mail Order network
Cost as of $4,800 In-
Today: $1,017 network

Aetna Medicare Value Plan (HMO) (H3931-108-0)
Organization: Aetna Medicare
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 $4,600 3.5 out of Enroll
Deductible: $95 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: $2 - Costs
Cost as of Reduction: $100, 31% Out of
Today: $782 No Pocket MTM Program : Yes
Spending
Mail Order Limit:
Cost as of $4,100 In-
Today: $1,017 network

Allwell Medicare (HMO) (H0724-003-0)
Organization: Allwell
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 $4,400 Plan too Enroll
Deductible: $125 Choice: Formulary: Yes new to be
Pharmacy Drug: $0.00 Plan measured
Status: Health: Health Plan Doctors for Drug Restrictions:
Standard $0.00 Deductible: $0 Most No
Cost-Sharing Drug Copay/ Services Lower Your Drug
Part B Coinsurance: $0 - Costs
Cost as of Premium $90, 30% Out of
Today: $796 Reduction: Pocket MTM Program : Yes
No Spending
Mail Order Limit:
Cost as of $4,900 In-
Today: $934 network

Humana Gold Choice H8145-032 (PFFS) (H8145-032-0)
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: [?] [?]