Page 14 - Cover Letter and Medicare Evaluation for Jamie Marshall

Your Prescription Drug Costs

These costs are for your prescription drugs and are based on the dosages and monthly quantities that
you use. These costs include premiums, deductible, and co-payments.

Pharmacy Information

Client's pharmacy: When you need a retail prescription filled or refilled, you will
usually get the lowest prices at one of your plan's preferred
CVS pharmacies. Some plans do not have preferred pharmacies.

Is CVS a preferred pharmacy in the following plans' networks?

Humana Walmart Value Rx Plan No, but Walmart is

Medicare Advantage plans are not included in this evaluation

y g

The lowest-cost Part D stand-alone plan for your drugs

To enroll in a plan, call its toll-free Humana Walmart Value Rx Plan
number

Enrollment number is (800) 281-6918

Est. annual costs for monthly refills $1,117.50 at CVS $1,053.32 at Walmart

Est. annual costs for mail-order refills $1,037

This plan's Medicare quality rating 3.5 out of 5 stars

Medicare Advantage plans' costs for your drugs

These two Medicare Advantage plans
include prescription drug and medical
coverage

Est. annual costs for monthly refills at Medicare Advantage plans are not included in this evaluation
CVS
Est. annual costs for mail-order refills

This plan's Medicare quality rating

4