Page 16 - Cover Letter & Evaluation for Patricia Letizia
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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 pharmacies. Some plans, though, do not have
CVS
preferred pharmacies.
Is CVS a preferred pharmacy in the following plans' pharmacy networks?
CVS is a preferred pharmacy
Aetna Medicare Premier Plan (PPO) Yes
in this plan
Walgreens, Costco, and
Network Health Medicare Go (PPO) No others are preferred
pharmacies
CVS is a preferred pharmacy
Humana Choice Plan (Local PPO) Yes in this plan but mail-order is
y g almost $500 less costly.
Rx drug costs in two Wisconsin Advantage plans
Aetna Medicare Premier Network Health Medicare Go
Plan (PPO) (PPO)
To enroll in a plan, call its toll-free
number (833) 859-6031 (800) 983-7587
Annual costs for monthly refills $204 at CVS $392 at Walgreens
Annual costs with mail-order refills $204 $306
This plan's Medicare quality rating 4 out of 5 stars 4 out of 5 stars
Rx drug costs in your current plan
Most Medicare Advantage plans Humana Choice PPO Plan
include prescription drug and
medical coverage (H5525-004)
Annual costs at CVS Pharmacy $611
Annual costs with mail-order refills $136
This plan's Medicare quality rating 4 out of 5 stars
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