Page 86 - Cover Letter and Evaluation for Debbie Workman

12/13/2017 Your Plan Results

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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.

These are the lowest-cost Part D stand-
Symbols alone plans for the Rx drugs that you
take. This list is sorted by the plans'
Nationwide Coverage costs if you get mail-order prescriptions
and refills. Costs include premiums,
Your Current Plan(s) deductible, and co-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

Prescription Drug Plans

22 plans were found in 99206 based on your search criteria. View 10 View 20 View All

Sort Results By
EnvisionRxPlus (PDP) (S7694-030-0)
Organization: EnvisionRx Plus
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $12.60 Annual Drug Deductible: All Your Drugs on Enroll
$300 Formulary :Yes
Pharmacy Status: 3 out of 5 stars
Preferred Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $1 - $34, 27% - 40% Lower Your Drug Costs
Annual: MTM Program : Yes
Mail Order
Annual: $223
Express Scripts Medicare - Saver (PDP) (S5660-246-0)
Organization: Express Scripts Medicare

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