Page 93 - Cover Letter and evaluation for Katherine Kensky

11/6/2017 Your Plan Results
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $56.10 Annual Drug Deductible: $0 All Your Drugs on Enroll
Formulary :Yes
Pharmacy Status: Drug Copay/ Coinsurance: 2 out of 5 stars
Preferred Cost- $4 - $42, 33% - 50% Drug Restrictions: Yes
Sharing Lower Your Drug Costs
Annual: $1,501 MTM Program : Yes
Mail Order
Annual: $1,456
Humana Walmart Rx Plan (PDP) (S5884-156-0)
Organization: Humana Insurance Company
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $20.40 Annual Drug Deductible: All Your Drugs on Enroll
$405 Formulary :Yes
Pharmacy Status: 3.5 out of 5 stars
Preferred Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $1 - $4, 21% - 35% Lower Your Drug Costs
Annual: $1,513 MTM Program : Yes
This plan is
Mail Order
Annual: $945 compared in your
Humana Preferred Rx Plan (PDP) (S5884-135-0) evaluation.
Organization: Humana Insurance Company
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $25.40 Annual Drug Deductible: All Your Drugs on Enroll
$405 Formulary :Yes
Pharmacy Status: 3.5 out of 5 stars
Preferred Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $0 - $1, 20% - 35% Lower Your Drug Costs
Annual: $1,549 MTM Program : Yes
Mail Order
Annual: $933 Lowest cost of any
Cigna-HealthSpring Rx Secure (PDP) (S5617-219-0) option
Organization: Cigna-HealthSpring Rx
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $63.80 Annual Drug Deductible: All Your Drugs on Enroll
$405 Formulary :Yes
Pharmacy Status: 2 out of 5 stars
Preferred Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $0 - $32, 25% - 39% Lower Your Drug Costs

Annual: $1,590 MTM Program : Yes
Mail Order
Annual: $1,479
Magellan Rx Medicare Basic (PDP) (S4607-011-0)
Organization: Magellan Rx Medicare
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $62.90 Annual Drug Deductible: All Your Drugs on Enroll
$405 Formulary :Yes
Pharmacy Status: 2 out of 5 stars
Preferred Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $1 - $5, 14% - 50% Lower Your Drug Costs
Annual: $1,629 MTM Program : Yes

Mail Order
Annual: $1,517

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