Page 102 - Cover Letter and Evaluation for John

10/9/2018 Your Plan Results
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Star Rating:
Costs: [?] [?] Copay [?] / Restrictions [?] Health and [?]
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $0.00 Annual Drug Doctor All Your Drugs on $4,030 Coming Soon Enrollment begins
Deductible: $0 Choice: Plan Formulary :Yes October 15, 2018
Pharmacy Drug: $0.00 Doctors for
Status: Health: Health Plan Most Services Drug Restrictions:
Standard Cost- $0.00 Deductible: $0 Yes
Sharing Drug Copay/ Out of Pocket Lower Your Drug
Part B Coinsurance: Spending Costs
Annual: $2,014 Premium $0 - $85, 33% Limit: $3,400
Reduction In-network MTM Program :
Mail Order :No Yes
Annual: $2,775
Brand New Day Classic Care II Plan (HMO) (H0838-037-0)
Organization: Brand New Day
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Star Rating:
Costs: [?] [?] Copay [?] / Restrictions [?] Health and [?]
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $0.00 Annual Drug Doctor All Your Drugs on $4,220 Coming Soon Enrollment begins
Deductible: $0 Choice: Plan Formulary :Yes October 15, 2018
Pharmacy Drug: $0.00 Doctors for
Status: Health: Health Plan Most Services Drug Restrictions:
Standard Cost- $0.00 Deductible: $0 Yes
Sharing Drug Copay/ Out of Pocket Lower Your Drug
Part B Coinsurance: Spending Costs
Annual: $2,044 Premium $0 - $90, 33% Limit: $3,400
Reduction In-network MTM Program :
Mail Order :No Yes
Annual: $2,810
Blue Shield 65 Plus (HMO) (H0504-026-0)
Organization: Blue Shield of California
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Star Rating:
Costs: [?] [?] Copay [?] / Restrictions [?] Health and [?]
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $0.00 Annual Drug Doctor All Your Drugs on $5,240 Coming Soon Enrollment begins
Deductible: $0 Choice: Plan Formulary :Yes October 15, 2018
Pharmacy Drug: $0.00 Doctors for
Status: Health: Health Plan Most Services Drug Restrictions:
Preferred Cost- $0.00 Deductible: $0 Yes
Sharing Drug Copay/ Out of Pocket Lower Your Drug
Part B Coinsurance: Spending Costs
Annual: $2,600 Premium $0 - $95, 33% Limit: $2,799
Reduction In-network MTM Program :
Mail Order :No Yes
Annual: $2,484
Health Net Gold Select (HMO) (H0562-101-2)
Organization: Health Net of California
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Star Rating:
Costs: [?] [?] Copay [?] / Restrictions [?] Health and [?]
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $0.00 Annual Drug Doctor All Your Drugs on $4,630 Coming Soon Enrollment begins
Deductible: $0 Choice: Plan Formulary :Yes October 15, 2018
Pharmacy Drug: $0.00 Doctors for
Status: Health: Health Plan Most Services Drug Restrictions:
Preferred Cost- $0.00 Deductible: $0 Yes
Sharing Drug Copay/ Out of Pocket Lower Your Drug
Part B Coinsurance: Spending Costs
Annual: $2,612 Premium $0 - $90, 33% Limit: $2,900
Reduction In-network MTM Program :
Mail Order :No Yes
Annual: $2,303

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