Page 30 - Evaluation for John Shartle

11/3/2017 Your Medicare Health Plan Comparison

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Your Plan Comparison
Zip Code: 19970
Current Coverage: Original Medicare
Current Subsidy: No Extra Help [?]
Select the tabs below for more detailed information about the plan health benefits, drug costs
and coverage and star ratings. Drug List ID: 6538469152
Password Date: 11/03/2017
Important Coverage Information

You are now viewing 2018 plan data. View 2017 plan data.

Symbols Not counting the Magellan plan (which has a
below-average quality rating), these are the two
Nationwide Coverage
lowest-cost plans for your Rx drugs. These are
* Estimated
both national plans and their 2018 costs are the

same in Maryland and in Delaware. Estimated
costs include premiums, deductible, and co-
payments. See next page for cost comparisons.

SilverScript Choice (PDP) Express Scripts Medicare - Value (PDP)

(S5601-010) Plan Type: (S5660-107) Plan Type:
Organization: SilverScript Organization: Express Scripts Medicare
Members: 1-866-235-5660 Members: 1-800-758-4574
711(TTY/TDD) 1-800-716-3231(TTY/TDD)
Non Members: 1-866-552-6106 Non Members: 1-866-477-5704
711(TTY/TDD) 1-800-716-3231(TTY/TDD)
Coverage: Provides drug coverage only. Coverage: Provides drug coverage only.
NOTE: Health Plan Benefits are based on Original Medicare NOTE: Health Plan Benefits are based on Original Medicare

Fixed Costs

Monthly Drug Plan Premium $29.50 Monthly Drug Plan Premium $26.00

Monthly Health Plan Premium N/A Monthly Health Plan Premium N/A
Annual Drug Deductible $0.00 Annual Drug Deductible $405.00
Medicare costs at a glance Medicare costs at a glance

Estimate of What YOU Will Pay for Drug Plan Premium and Drug Costs

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