Page 110 - Cover Letter and Evaluation for John

10/9/2018 Your Plan Results
Retail $0.00 Annual Drug Doctor All Your Drugs on $22,520 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:
Out-of-network $0.00 Deductible: $0 No
Drug Copay/ Out of Pocket Lower Your Drug
Annual: Part B Coinsurance: Spending Costs
$20,697 Premium $5 - $95, 33% Limit: $1,499
Reduction In-network MTM Program :
Mail Order :No Yes
Annual: $2,217
AARP MedicareComplete SecureHorizons Premier (HMO) (H0543-
166-0)
Organization: UnitedHealthcare
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 $17.70 Annual Drug Doctor All Your Drugs on $3,190 † Coming Soon Enrollment begins
Annual: Drug: Deductible: $0 Choice: Plan Formulary :Not October 15, 2018
†
$1,148 $17.70 Health Plan Doctors for Available
Deductible: $0 Most Services Drug Restrictions:
Mail Order Health: Out of Pocket Not Available
Annual: Not $0.00 Drug Copay/ Spending
Available Coinsurance: Limit: $1,500 Lower Your Drug
Part B $0 - $100, 33% Costs
Premium In-network
Reduction MTM Program :
:No Yes
AARP MedicareComplete SecureHorizons Focus (HMO) (H0543-
170-0)
Organization: UnitedHealthcare
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 $2,960 † Coming Soon Enrollment begins
†
Annual: $936 Drug: $0.00 Deductible: $0 Choice: Plan Formulary :Not October 15, 2018
Health Plan Doctors for Available
Mail Order Health: Deductible: $0 Most Services Drug Restrictions:
Annual: Not $0.00 Out of Pocket Not Available
Available Drug Copay/
Part B Coinsurance: Spending Lower Your Drug
Premium $0 - $100, 33% Limit: $1,500 Costs
Reduction In-network
:No MTM Program :
Yes
AARP MedicareComplete SecureHorizons Plan 2 (HMO) (H0543-
144-0)
Organization: UnitedHealthcare
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 $3,400 † Coming Soon Enrollment begins
†
Annual: $960 Drug: $0.00 Deductible: $0 Choice: Plan Formulary :Not October 15, 2018
Health Plan Doctors for Available
Mail Order Health: Deductible: $0 Most Services Drug Restrictions:
Annual: Not $0.00 Out of Pocket Not Available
Available Drug Copay/
Part B Coinsurance: Spending Lower Your Drug
Premium $0 - $100, 33% Limit: $2,900 Costs
Reduction In-network
:No MTM Program :
Yes
UnitedHealthcare MedicareComplete Assure (HMO) (H0543-153-
0)
Organization: UnitedHealthcare

https://www.medicare.gov/find-a-plan/results/planresults/plan-list.aspx 11/12