Page 80 - Cover Letter and Evaluation for Debbie Workman

12/13/2017 Your Medicare Health Plan Details

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Your Plan Details

Zip Code: 99206
Current Coverage: Original Medicare
Current Subsidy: No Extra Help [?]
Select the tabs below for more detailed information about the plan health benefits, drug costs Drug List ID: 2065979904
and more coverage and star ratings.
Password Date: 12/13/2017
Important Coverage Information

You are now viewing 2018 plan data. View 2017 plan data.
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Some Vision Coverage Some Hearing Coverage
* Estimated

AARP MedicareComplete 3315 Central AVE Overall Star Rating: [?] Enroll
Hot Springs, AR 71913
Plan 1 (HMO)
(H1286-002-0) Members: 4 out of 5 stars

1-800-643-4845
Organization: UnitedHealthcare 711 (TTY/TDD)
Plan Type: Non Members:
1-800-555-5757 $204 annual costs
711 (TTY/TDD) for your Rx drugs
with mail-order
Fixed Costs prescriptions --
includes the plan's

Monthly Drug Plan Premium [?] $17 monthly Rx $17.00
drug premium.
Monthly Health Plan Premium [?] $0.00
Annual Drug Deductible [?] $180.00

Medicare costs at a glance

Estimate of What YOU Will Pay for Drug Plan Premium and Drug Costs

Full Year Cost (based on January enrollment) [?]
Walgreens #7846 $352.68
CVS Pharmacy # $349.44
Mail Order Pharmacy $204.00
Lower your drug costs

Estimated Full Cost the Plan Charges Medicare for Your Drugs

Drug Costs During Coverage Levels

https://www.medicare.gov/find-a-plan/results/planresults/plan-details.aspx?cntrctid=H1286&plnid=002&sgmntid=0#plan_drug_cost 1/3