Page 31 - Evaluation for John Shartle
P. 31

11/3/2017                                     Your Medicare Health Plan Comparison

             Cost at Walgreens #11044    Lowest retail cost     Cost at CVS Pharmacy

             January                 $2,225.47                  January                 $2,969.45
             Enrollment                                         Enrollment
             Cost at CVS Pharmacy                               Cost at Walgreens #11044
                                                                                                  Lowest mail-order
             January                 $2,169.19                  January                 $2,940.25  cost
             Enrollment                                         Enrollment

             Cost at mail order pharmacy                        Cost at mail order pharmacy
             January                 $2,055.76                  January                 $2,027.35
             Enrollment                                         Enrollment
             Lower your drug costs                              Lower your drug costs

               Estimated Full Cost the Plan Charges Medicare for Your Drugs

               Estimated Monthly Drug Costs

             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       $171.83                  Deductible met  1st       $449.00
                                     2nd       $79.83                                   2nd       $46.00
                                     3rd       $171.83                                  3rd       $389.53

                                     4th       $79.83                                   4th       $46.00
                                     5th       $171.83                                  5th       $389.53
                                     6th       $79.83                                   6th       $46.00
                 Donut Hole reached  7th       $308.55               Donut Hole reached  7th      $516.31
             MILESTONES              MONTH     YOUR COST        MILESTONES              MONTH     YOUR COST
                                     8th       $168.96                                  8th       $163.48

                                     9th       $299.39                                  9th       $283.72
                                     10th      $168.96                                  10th      $163.48
                                     11th      $299.39                                  11th      $283.72
                                     12th      $168.96                                  12th      $163.48

             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
             approximately a 50% discount on covered brand      a 50% discount on covered brand drugs. Medicare has
             drugs. Medicare has also increased its coverage of  also increased its coverage of generic drugs for
             generic drugs for beneficiaries in the coverage gap so  beneficiaries in the coverage gap so that beginning in
             that beginning in 2011 you will pay less for generic  2011 you will pay less for generic drugs as well. The
             drugs as well. The drugs eligible for the brand    drugs eligible for the brand discount or the additional
             discount or the additional generic savings may change  generic savings may change based on the information
             based on the information we have available.        we have available.

               Drug Coverage Information


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