Page 50 - Cover Letter and Evaluation for Debbie Workman

12/13/2017 Your Plan Results

Return to previous page
Your Plan Results
Zip Code: 99206
Current Coverage: Original Medicare
Current Subsidy: No Extra Help [?]
Drug List ID: 2065979904
Your plan results are organized by plan type and are initially sorted by lowest Password Date: 12/13/2017
estimated cost. To view more plans, select View 20 or View All. Select any plan Important Coverage Information
name for details. Compare up to 3 plans by using the checkboxes and selecting
Compare Plans. The costs displayed are estimates; your actual costs may vary.

You are now viewing 2018 plan data. View 2017 plan data. This is a list of the 15 Medicare
Advantage plans in Spokane County
that include Rx drug coverage. This list
Symbols is sorted by the plans' costs for your
drugs if you get mail-order refills, with
Some Dental Coverage Some Vision Coverage Nationwide Coverage Some Hearing Coverage
the lowest-cost plans listed first. Costs
include premiums, deductible, and co-
Your Current Plan(s) payments.
Original Medicare (H0001-001-0)
Includes Part A (Hospital Insurance) and/or Part B (Medical Insurance) - Excludes Part D Drug
Coverage
Estimated Monthly Deductibles: Health Benefits: [?] Drug Coverage [?] Estimated Overall Star
Annual Drug Premium: [?] and Drug , Drug Restrictions Annual Health Rating: [?]
Costs: [?] [?] Copay [?] / [?] and Drug Costs:
Coinsurance: [?]
[?]
Retail Standard Part B Doctor Choice: Any N/A $7,760 Not Available
Annual: Part B: Deductible: $183 Willing Doctor Includes $3,883
$134 for drug costs
Out of Pocket Spending
Limit: Not Applicable

Medicare Health Plans with Drug Coverage

15 plans were found in 99206 based on your search criteria. View 10 View 15 This plan is
compared in your
evaluation.
Sort Results by
Humana Gold Plus H5619-060 (HMO) (H5619-060-0)
Organization: Arcadian Health Plan, Inc.
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall Star
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Rating: [?]
Costs: [?] [?] Copay [?] / Restrictions [?] Health and
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $0.00 Annual Drug Doctor Choice: All Your Drugs on $3,830 Enroll
Deductible: Plan Doctors Formulary :Yes
Pharmacy Drug: $0.00 $180 for Most 4 out of 5
Status: Health: Services Drug Restrictions: stars
Preferred Cost- $0.00 Health Plan Yes
Sharing Deductible: $0 Out of Pocket Lower Your Drug
Part B Drug Copay/ Spending Costs
Annual: Premium Coinsurance: $4 Limit: $5,900
Reduction - $100, 29% In-network MTM Program :
Mail Order :No Yes
Annual: $40

https://www.medicare.gov/find-a-plan/results/planresults/plan-list.aspx 1/5