Page 51 - Cover Letter and Evaluation for Debbie Workman

12/13/2017 Your Plan Results
Humana Gold Plus H5619-102 (HMO) (H5619-102-0)
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 $33.00 Annual Drug Doctor Choice: All Your Drugs on $3,870 Enroll
Deductible: Plan Doctors Formulary :Yes
Pharmacy Drug: $0.00 $150 for Most 4 out of 5
Status: Health: Services Drug Restrictions: stars
Preferred Cost- $33.00 Health Plan Yes
Sharing Deductible: $0 Out of Pocket Lower Your Drug
Part B Drug Copay/ Spending Costs
Annual: Premium Coinsurance: $4 Limit: $5,000
Reduction - $100, 30% In-network MTM Program :
Mail Order :No Yes
Annual: $40
Allwell Medicare (HMO) (H0029-004-0)
Organization: Allwell
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 $3,710 Plan too new Enroll
Deductible: Plan Doctors Formulary :Yes to be
Pharmacy Drug: $0.00 $200 for Most measured
Status: Health: Services Drug Restrictions:
Preferred Cost- $0.00 Health Plan No
Sharing Deductible: $0 Out of Pocket Lower Your Drug
Part B Drug Copay/ Spending Costs This plan is
Annual: Premium Coinsurance: $0 Limit: $5,900
Reduction - $90, 29% In-network MTM Program : compared in your
Mail Order :No Yes
Annual: $190 evaluation
AARP MedicareComplete Plan 1 (HMO) (H1286-002-0)
Organization: UnitedHealthcare
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 $17.00 Annual Drug Doctor Choice: All Your Drugs on $3,820 Enroll
Deductible: Plan Doctors Formulary :Yes
Pharmacy Drug: $17.00 $180 for Most 4 out of 5
Status: Health: Services Drug Restrictions: stars
Standard Cost- $0.00 Health Plan Yes
Sharing Deductible: $0 Out of Pocket Lower Your Drug
Part B Drug Copay/ Spending Costs
Annual: Premium Coinsurance: $2 Limit: $5,500
Reduction - $95, 29% In-network MTM Program :
Mail Order :No Yes
Annual: $204
Kaiser Permanente Medicare Advantage Centennial (HMO) (H5050-
021-0)
Organization: Kaiser Foundation Health Plan of Washington
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 $29.00 Annual Drug Doctor Choice: All Your Drugs on $8,090 Enroll
Deductible: Plan Doctors Formulary :Yes
Pharmacy Drug: $0.00 $350 for Most 4.5 out of 5
Status: Health: Services Drug Restrictions: stars
Out-of-network $29.00 Health Plan Out of Pocket No
Deductible: $0
Annual: Part B Drug Copay/ Spending Lower Your Drug
Costs
Premium Coinsurance: $0 Limit: $6,700
Mail Order Reduction - $95, 25% In-network MTM Program :
Annual: $239 :No Yes

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