Page 104 - Cover Letter and Evaluation for John

10/9/2018 Your Plan Results
Retail $0.00 Annual Drug Doctor All Your Drugs on $6,120 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 No
Sharing Drug Copay/ Out of Pocket Lower Your Drug
Part B Coinsurance: Spending Costs
Annual: $2,732 Premium $0 - $100, 33% Limit: $4,900
Reduction In-network MTM Program :
Mail Order :No Yes
Annual: $2,456
Central Health Premier Plan (HMO) (H5649-004-0)
Organization: Central Health Medicare Plan
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 $34.80 Annual Drug Doctor All Your Drugs on $5,420 Coming Soon Enrollment begins
Deductible: Choice: Plan Formulary :Yes October 15, 2018
Pharmacy Drug: $415 Doctors for
Status: $34.80 Most Services Drug Restrictions:
Standard Cost- Health: Health Plan Yes
Sharing $0.00 Deductible: $0 Out of Pocket Lower Your Drug
Drug Copay/ Spending Costs
Annual: $2,777 Part B Coinsurance: Limit: $6,700
Premium $0 - $10, 25% In-network MTM Program :
Mail Order Reduction Yes
Annual: $2,610 :No
Brand New Day Classic Choice Medi-Medi Plan (HMO) (H0838-
033-0)
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 $34.80 Annual Drug Doctor All Your Drugs on $5,860 Coming Soon Enrollment begins
Deductible: Choice: Plan Formulary :Yes October 15, 2018
Pharmacy Drug: $415 Doctors for
Status: $34.80 Most Services Drug Restrictions:
Standard Cost- Health: Health Plan Yes
Sharing $0.00 Deductible: $0 Out of Pocket Lower Your Drug
Drug Copay/ Spending Costs
Annual: $3,115 Part B Coinsurance: Limit: $6,700
Premium 0% - 25% In-network MTM Program :
Mail Order Reduction Yes
Annual: $4,111 :No
Health Net Seniority Plus Sapphire Premier (HMO) (H3561-004-0)
Organization: HEALTH NET COMMUNITY SOLUTIONS, INC.
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 $34.80 Annual Drug Doctor All Your Drugs on $5,840 Coming Soon Enrollment begins
Deductible: Choice: Plan Formulary :Yes October 15, 2018
Pharmacy Drug: $200 Doctors for
Status: $34.80 Most Services Drug Restrictions:
Standard Cost- Health: Health Plan Yes
Sharing $0.00 Deductible: $0 Out of Pocket Lower Your Drug
Drug Copay/ Spending Costs
Annual: $3,156 Part B Coinsurance: Limit: $6,700
Premium $0 - $100, 29% In-network MTM Program :
Mail Order Reduction Yes
Annual: $3,139 :No
Alignment Health Plan CalPlus (HMO) (H3815-009-0)
Organization: Alignment Health Plan

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