Page 15 - Cover Letter and Evaluation for Debbie Workman

Plans that appear to meet your criteria (cont'd)

Humana Gold Plus AARP Medicare
Plan name Medigap Plan F Medigap Plan L
HMO Plan Complete Plan 1

Toll-Free Number NA NA 800-833-2364 800-555-5757

Estimated annual premiums for medical coverage
lity ratings from Medicare web site (best rating = 5 stars)
2018 standard Part B

premium of $134 a $1,608 $1,608 $1,608 $1,608
month*

Health plan annual
premiums (Medigap $2,400 $1,650 $0 $0
premiums are estimates)

Total $4,008 $3,258 $1,608 $1,608

Minimum costs for Medicare-covered services

Total medical premiums $4,008 $3,258 $1,608 $1,608

(from above)
Plan health deductible

(includes Part B deductible if $0 $183 $0 $0
not covered by plan**)

Annual Rx costs, mail-

order (premiums, $223 $223 $40 $204
deductibles, co-pays)
Total Minimum Costs
(includes health deductible and $4,231 $3,664 $1,648 $1,812
costs for your Rx drugs)
Cost-sharing for doctors office visits

=
In-Network Primary
Care Co-Pays $10 $10
No co-pays for You pay 5% of
In-Network Specialist Medicare-covered Medicare approved
Co-Pays services amount $50 $45
Out-of-Network
Co-Pays Not covered Not covered

*This is 2018 standard Part B premium for new enrollees (those with higher incomes may pay more).
**Part B deductible in 2018 is $183.

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