Page 41 - APPENDICES for Stephen Spero
P. 41
MONTHLY PREMIUM
$0.00
Includes: Health & drug coverage
Doesn't include: $144.60 Standard Part B premium
YEARLY DRUG & PREMIUM COST
$4,820.80
Retail pharmacy: Estimated total drug + premium cost
Doesn't include: Health costs
OTHER COSTS
$0
Health deductible
$0.00
Drug deductible
$3,400 In-network Maximum you pay for health services
View More Information
Scripps Classic offered by SCAN Health Plan (HMO)
SCAN Health Plan | Plan ID: H5425-005-0
Star rating:
MONTHLY PREMIUM
$0.00
Includes: Health & drug coverage
Doesn't include: $144.60 Standard Part B premium
YEARLY DRUG & PREMIUM COST
$4,855.50
Retail pharmacy: Estimated total drug + premium cost
