Page 71 - Cover Letter & Evaluation for Isaac Kapon

10/4/2017 Your Plan Results
AARP MedicareComplete Plan 1 (HMO) (H0609-028-0)
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 $0.00 Annual Drug Doctor Choice: All Your Drugs on $3,590 Coming Soon Enrollment begins
Annual: Deductible: $0 Plan Doctors Formulary :No October 15, 2017
Drug: $0.00 for Most
Mail Order Health: Health Plan Services Drug Restrictions:
Annual: N/A $0.00 Deductible: $0 Out of Pocket No
Drug Copay/ Lower Your Drug
Part B Coinsurance: $2 Spending Costs
Premium - $100, 33% Limit: $2,500
Reduction In-network MTM Program :
:No Yes

Aetna Medicare Select Plan (HMO) (H3931-094-0)
Organization: Aetna Medicare
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 $4,330 Coming Soon Enrollment begins
Annual: Deductible: $0 Plan Doctors Formulary :No October 15, 2017
Drug: $0.00 for Most
Mail Order Health: Health Plan Services Drug Restrictions:
Annual: N/A $0.00 Deductible: $0 Out of Pocket No
Drug Copay/ Lower Your Drug
Part B Coinsurance: $2 Spending Costs
Premium - $100, 33% Limit: $4,500
Reduction In-network MTM Program :
:No Yes

Senior Dimensions Southern Nevada (HMO) (H2931-002-0)
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 $0.00 Annual Drug Doctor Choice: All Your Drugs on $3,700 Coming Soon Enrollment begins
Annual: Deductible: $0 Plan Doctors Formulary :No October 15, 2017
Drug: $0.00 for Most
Mail Order Health: Health Plan Services Drug Restrictions:
Annual: N/A $0.00 Deductible: $0 Out of Pocket No
Drug Copay/ Lower Your Drug
Part B Coinsurance: $2 Spending Costs
Premium - $100, 33% Limit: $2,500
Reduction In-network MTM Program :
:No Yes

Anthem StartSmart Plus (HMO) (H4346-009-0)
Organization: Anthem Blue Cross and Blue Shield
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 $3,500 Coming Soon Enrollment begins
Annual: Deductible: $0 Plan Doctors Formulary :No October 15, 2017
Drug: $0.00 for Most
Mail Order Health: Health Plan Services Drug Restrictions:
Annual: N/A $0.00 Deductible: $0 Out of Pocket No
Drug Copay/ Lower Your Drug
Part B Coinsurance: $5 Spending Costs
Premium - $90, 33% Limit: $3,400
Reduction In-network MTM Program :
:Yes Yes

Humana Gold Plus H6622-028 (HMO) (H6622-028-0)
Organization: Humana WI Health Organization Insurance Corp

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