Page 34 - Cover Letter and Evaluation for Chris Parlin

10/10/2017 Your Plan Results
Retail $29.40 Annual Drug Deductible: $0 All Your Drugs on Formulary Coming Soon Enrollment begins
:Yes October 15, 2017
Pharmacy Status: Drug Copay/ Coinsurance:
Preferred Cost- $3 - $38, 33% - 38% Drug Restrictions: Yes
Sharing Lower Your Drug Costs
Annual: $1,502 MTM Program : Yes
Mail Order
Annual: $1,333
EnvisionRxPlus (PDP) (S7694-002-0) Lowest-cost mail
Organization: EnvisionRx Plus order
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $12.60 Annual Drug Deductible: All Your Drugs on Formulary Coming Soon Enrollment begins
$300 :Yes October 15, 2017
Pharmacy Status:
Preferred Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $1 - $29, 27% - 38% Lower Your Drug Costs
Annual: $1,509 MTM Program : Yes
Mail Order
Annual: $1,327
Aetna Medicare Rx Select (PDP) (S5810-276-0)
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 $17.70 Annual Drug Deductible: All Your Drugs on Formulary Coming Soon Enrollment begins
$405 :Yes October 15, 2017
Pharmacy Status:
Preferred Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $0 - $47, 25% - 39% Lower Your Drug Costs
Annual: $1,595 MTM Program : Yes
Mail Order
Annual: N/A
First Health Part D Value Plus (PDP) (S5768-126-0)
Organization: First Health Part D
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $56.30 Annual Drug Deductible: $0 All Your Drugs on Formulary Coming Soon Enrollment begins
:Yes October 15, 2017
Pharmacy Status: Drug Copay/ Coinsurance:
Preferred Cost- $1 - $47, 33% - 50% Drug Restrictions: Yes
Sharing Lower Your Drug Costs
Annual: $1,612 MTM Program : Yes
Mail Order
Annual: $1,611
Blue MedicareRx Value Plus (PDP) (S2893-001-0)
Organization: Blue MedicareRx
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $38.20 Annual Drug Deductible: All Your Drugs on Formulary Coming Soon Enrollment begins
$235 :Yes October 15, 2017
Pharmacy Status:
Preferred Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $2 - $35, 28% - 40% Lower Your Drug Costs
Annual: $1,644 MTM Program : Yes
Mail Order
Annual: $1,392
WellCare Extra (PDP) (S4802-099-0)
Organization: WellCare
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $65.20 Annual Drug Deductible: $0 All Your Drugs on Formulary Coming Soon Enrollment begins
:Yes October 15, 2017
Pharmacy Status: Drug Copay/ Coinsurance:
Preferred Cost- $0 - $34, 33% - 35% Drug Restrictions: Yes
Sharing Lower Your Drug Costs
Annual: $1,679 MTM Program : Yes
Mail Order
Annual: $1,458
WellCare Classic (PDP) (S4802-076-0)
Organization: WellCare
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:

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