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9/12/2017 Your Plan Results

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Your Plan Results
Zip Code: 90049
Current Coverage: Original Medicare
Current Subsidy: No Extra Help [?]
Drug List ID: 0226651648
Your plan results are organized by plan type and are initially sorted by lowest Password Date: 09/12/2017
estimated cost. To view more plans, select View 20 or View All. Select any plan Important Coverage Information
name for details. Compare up to 3 plans by using the checkboxes and selecting
Compare Plans. The costs displayed are estimates; your actual costs may vary.

Symbols
This is a list of the 10
lowest-cost stand-alone
Nationwide Coverage
plans for the drugs that you
take. The list is sorted by
Your Current Plan(s) each plan's costs for your
Original Medicare (H0001-001-0) drugs if you get refills at
CVS. The lowest-cost plans
Includes Part A (Hospital Insurance) and/or Part B (Medical Insurance) - Excludes Part D Drug
Coverage are listed first.
Estimated Monthly Deductibles: Health Benefits: [?] Drug Coverage [?] Estimated Overall Star
Annual Drug Premium: [?] and Drug , Drug Restrictions Annual Health Rating: [?]
Costs: [?] [?] Copay [?] / [?] and Drug Costs:
Coinsurance: [?]
[?]
Retail Standard Part B Doctor Choice: Any N/A $5,050 Not Available
Cost as of Today: Part B: Deductible: $183 Willing Doctor Includes $1,631
$408 $109 for drug costs
Out of Pocket Spending
Limit: Not Applicable

Prescription Drug Plans
Assumes you will
24 plans were found in 90049 based on your search criteria. View 10 View 20 View All enroll effective
October 1.

Sort Results By
Humana Walmart Rx Plan (PDP) (S5884-178-0)
Organization: Humana Insurance Company
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $17.00 Annual Drug Deductible: All Your Drugs on Enroll
$400 Formulary :Yes
Pharmacy Status: 3 out of 5 stars
Standard Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $1 - $4, 20% - 35% Lower Your Drug Costs
Cost as of Today: MTM Program : Yes
$103
Mail Order
Cost as of Today:
$67
SilverScript Choice (PDP) (S5601-064-0)
Organization: SilverScript

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