Page 94 - Cover Letter and evaluation for Katherine Kensky

11/6/2017 Your Plan Results
Aetna Medicare Rx Select (PDP) (S5810-284-0)
Organization: Aetna Medicare
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $17.80 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 - $47, 25% - 42% Lower Your Drug Costs
Annual: $1,939 MTM Program : Yes
Mail Order
Annual: N/A
Humana Enhanced (PDP) (S5884-009-0)
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 $77.70 Annual Drug Deductible: $0 All Your Drugs on Enroll
Formulary :Yes
Pharmacy Status: Drug Copay/ Coinsurance: 3.5 out of 5 stars
Preferred Cost- $3 - $42, 33% - 44% Drug Restrictions: Yes
Sharing Lower Your Drug Costs
Annual: $2,279 MTM Program : Yes

Mail Order
Annual: $1,733
AARP MedicareRx Walgreens (PDP) (S5921-392-0)
Organization: UnitedHealthcare
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $26.70 Annual Drug Deductible: All Your Drugs on Enroll
$405 Formulary :No
Pharmacy Status: 3.5 out of 5 stars
Standard Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $0 - $31, 25% - 32% Lower Your Drug Costs
Annual: $2,308 MTM Program : Yes
Mail Order
Annual: $2,070
WellCare Classic (PDP) (S4802-082-0)
Organization: WellCare
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $26.70 Annual Drug Deductible: All Your Drugs on Enroll
$405 Formulary :No
Pharmacy Status: 2.5 out of 5 stars
Preferred Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $0 - $31, 25% - 42% Lower Your Drug Costs
Annual: $2,372 MTM Program : Yes
Mail Order
Annual: $2,293

Notes:
Your costs may be different depending on your Part B premium, any Part D penalty that may apply, and whether you qualify for
Extra Help from Medicare paying your drug costs.

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