Page 55 - Cover Letter & Evaluation for Patricia Letizia

10/10/2018 Your Plan Results
Retail $24.00 Annual Drug Doctor All Your Drugs on $3,100 Enrollment begins
Deductible: $95 Choice: Any Formulary :Yes October 15, 2018
Pharmacy Drug: Doctor 4 out of 5
Status: $17.00 Health Plan Drug Restrictions: stars
Preferred Cost- Health: Deductible: $0 Out of Pocket Yes
Sharing $7.00 Drug Copay/ Spending Lower Your
Coinsurance: Limit: $7,000 Drug Costs
Annual: $204 Part B $0 - $100, 31% In and Out-
Premium of-network MTM Program :
Mail Order Reduction $4,200 In- Yes
Annual: $204 :No network

Anthem MediBlue Plus (HMO) (H9525-004-0)
Organization: Anthem Blue Cross and Blue Shield
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Star
Costs: [?] [?] Copay [?] / Restrictions [?] Health and Rating: [?]
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $0.00 Annual Drug Doctor All Your Drugs on $3,290 Enrollment begins
Deductible: Choice: Plan Formulary :Yes October 15, 2018
Pharmacy Drug: $0.00 $140 Doctors for 3 out of 5
Status: Health: Most Services Drug Restrictions: stars
Preferred Cost- $0.00 Health Plan No
Sharing Deductible: $0 Out of Pocket Lower Your
Part B Drug Copay/ Spending Drug Costs
Annual: $264 Premium Coinsurance: Limit: $4,900
Reduction $0 - $95, 30% In-network MTM Program :
Mail Order :No Yes
Annual: $176
ProHealth Senior Preferred Value (w/Rx) (HMO) (H5262-012-0)
Organization: Senior Preferred
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Star
Costs: [?] [?] Copay [?] / Restrictions [?] Health and Rating: [?]
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $0.00 Annual Drug Doctor All Your Drugs on $3,560 Enrollment begins
Deductible: Choice: Plan Formulary :Yes October 15, 2018
Pharmacy Drug: $0.00 $250 Doctors for 4.5 out of 5
Status: Health: Most Services Drug Restrictions: stars
Standard Cost- $0.00 Health Plan Yes
Sharing Deductible: $0 Out of Pocket Lower Your
Part B Drug Copay/ Spending Drug Costs
Annual: $300 Premium Coinsurance: Limit: $5,900
Reduction $4 - $47, 28% In-network MTM Program :
Mail Order :No - 40% Yes
Annual: $144
Aetna Medicare Value Plan (PPO) (H5521-195-0)
Organization: Aetna Medicare
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Star This plan is
Costs: [?] [?] Copay [?] / Restrictions [?] Health and Rating: [?]
Coinsurance: and Other Drug compared in your
[?] Programs: Costs: [?]
evaluation.
Retail $0.00 Annual Drug Doctor All Your Drugs on $3,690 Enrollment begins
Deductible: $95 Choice: Any Formulary :Yes October 15, 2018
Pharmacy Drug: $0.00 Doctor 4 out of 5
Status: Health: Health Plan Drug Restrictions: stars
Preferred Cost- $0.00 Deductible: $0 Out of Pocket Yes
Sharing Drug Copay/ Spending Lower Your
Part B Coinsurance: Limit: $7,000 Drug Costs
Annual: $304 Premium $0 - $100, 31% In and Out-
Reduction of-network MTM Program :
Mail Order :No $4,500 In- Yes
Annual: $259 network

Network Health Medicare Go (PPO) (H5215-009-0)
Organization: Network Health Medicare Advantage Plans

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