Page 97 - Cover Letter and evaluation for Katherine Kensky

11/6/2017 Your Medicare Health Plan Comparison

Cost at Walmart Pharmacy 10-4556 Cost at CVS Pharmacy

January $1,403.84 January $1,582.26
Enrollment Enrollment
Cost at CVS Pharmacy Cost at Walmart Pharmacy 10-4556

January $1,404.36 January $1,549.38
Enrollment Enrollment

Cost at mail order pharmacy Cost at mail order pharmacy
January $1,387.44 January $933.27
Enrollment Enrollment
Lower your drug costs Lower your drug costs

Estimated Full Cost the Plan Charges Medicare for Your Drugs

Estimated Monthly Drug Costs Lowest-cost option

Monthly Drug Costs at Retail Pharmacies Monthly Drug Costs at Retail Pharmacies
View Drug Cost Summary View Drug Cost Summary
MILESTONES MONTH YOUR COST MILESTONES MONTH YOUR COST
1st $148.40 1st $235.73
2nd $88.24 2nd $112.62
3rd $148.40 Deductible met 3rd $235.73
Deductible met 4th $88.24 4th $52.54

5th $146.32 5th $175.65
6th $86.32 6th $52.54

MILESTONES 7th $146.32 MILESTONES 7th $175.65
MONTH
YOUR COST
MONTH
YOUR COST
8th $86.32 8th $52.54
9th $146.32 9th $175.65
10th $86.32 10th $52.54
11th $146.32 11th $175.65
12th $86.32 12th $52.54

Monthly Drug Costs Estimator Monthly Drug Costs Estimator
View monthly costs View monthly costs
comparison charts. comparison charts.

View monthly drug cost details by selected drugs View monthly drug cost details by selected drugs
Starting January 1, 2011, if you reach the coverage Starting January 1, 2011, if you reach the coverage
gap (also called the "donut hole") in your Medicare gap (also called the "donut hole") in your Medicare
prescription drug coverage, you will get prescription drug coverage, you will get
approximately a 50% discount on covered brand approximately a 50% discount on covered brand
drugs. Medicare has also increased its coverage of drugs. Medicare has also increased its coverage of
generic drugs for beneficiaries in the coverage gap so generic drugs for beneficiaries in the coverage gap so
that beginning in 2011 you will pay less for generic that beginning in 2011 you will pay less for generic
drugs as well. The drugs eligible for the brand drugs as well. The drugs eligible for the brand
discount or the additional generic savings may change discount or the additional generic savings may change
based on the information we have available. based on the information we have available.

Drug Coverage Information

https://www.medicare.gov/find-a-plan/results/planresults/plan-compare.aspx 2/4