Page 36 - SAMPLE

2/24/2017 Your Plan Results
Freedom Savings Plan (HMO) (H5427­052­0)
Organization: Freedom Health, Inc.
Estimated Annual Monthly Deductibles: Health Benefits: Estimated Overall Star
Drug Costs: [?] Premium: [?] [?] [?] Annual Health Rating: [?]
and Drug Costs:
[?]
Retail $0.00 Health Plan Doctor Choice: $6,970 Enroll
Cost as of Today: Deductible: $0 Plan Doctors for Includes $5,111 for
$4,259 Part B Most Services drug costs 4.5 out of 5 stars
Premium
Reduction Out of Pocket
[?] : Yes Spending Limit:
$3,400 In­
network

HumanaChoice R5826­018 (Regional PPO) (R5826­018­0)
Organization: Humana Insurance Company
Estimated Annual Monthly Deductibles: Health Benefits: Estimated Overall Star
Drug Costs: [?] Premium: [?] [?] [?] Annual Health Rating: [?]
and Drug Costs:
[?]
Retail $0.00 Health Plan Doctor Choice: $7,590 Enroll
Cost as of Today: Deductible: Any Doctor Includes $5,111 for
$4,259 Part B $975 annual drug costs 3 out of 5 stars
Premium deductible Out of Pocket
Reduction Spending Limit:
[?] : No $10,000 In and
Out­of­network
$5,000 In­
network

Health First Secure Plan (HMO) (H1099­009­0)
Organization: Health First Health Plans, Inc.
Estimated Annual Monthly Deductibles: Health Benefits: Estimated Overall Star
Drug Costs: [?] Premium: [?] [?] [?] Annual Health Rating: [?]
and Drug Costs:
[?]
Retail $0.00 Health Plan Doctor Choice: $7,940 Enroll
Cost as of Today: Deductible: $0 Plan Doctors for Includes $5,111 for
$4,259 Part B Most Services drug costs 4 out of 5 stars
Premium
Reduction Out of Pocket
[?] : No Spending Limit:
$3,400 In­
network

AARP MedicareComplete Choice Essential (Regional PPO) (R7444­
004­0)
Organization: UnitedHealthcare
Estimated Annual Monthly Deductibles: Health Benefits: Estimated Overall Star
Drug Costs: [?] Premium: [?] [?] [?] Annual Health Rating: [?]
and Drug Costs:
[?]
Retail $0.00 Health Plan Doctor Choice: $8,400 Enroll
Cost as of Today: Deductible: $0 Any Doctor Includes $5,111 for
$4,259 Part B drug costs 4 out of 5 stars
Premium Out of Pocket
Reduction Spending Limit:
[?] : No $10,000 In and
Out­of­network
$6,700 In­
network

Notes:
Your costs may be different depending on your Part B premium, any Part D penalty that may apply, and whether you qualify for
Extra Help from Medicare paying your drug costs.

https://www.medicare.gov/find­a­plan/results/planresults/plan­list.aspx 5/6