Page 84 - Cover Letter and Evaluation for John

10/9/2018 Your Plan Results
Retail $83.40 Annual Drug Deductible: All Your Drugs on Formulary Coming Soon Enrollment begins
$415 :Yes October 15, 2018
Pharmacy Status:
Standard Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $1 - $30, 25% - 33% Lower Your Drug Costs

Annual: $3,605 MTM Program : Yes

Mail Order
Annual: $4,085
Humana Enhanced (PDP) (S5884-030-0)
Organization: Humana
Estimated Annual Monthly Deductibles: [?] and Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Drug Copay [?] / Restrictions [?] and Other Rating: [?]
[?] Coinsurance: [?] Programs:
Retail $82.80 Annual Drug Deductible: $0 All Your Drugs on Formulary Coming Soon Enrollment begins
:Yes October 15, 2018
Pharmacy Status: Drug Copay/ Coinsurance:
Standard Cost- $5 - $47, 33% - 50% Drug Restrictions: Yes
Sharing Lower Your Drug Costs

Annual: $3,761 MTM Program : Yes

Mail Order
Annual: $3,559
Aetna Medicare Rx Select (PDP) (S5810-295-0)
Organization: Aetna Medicare
Estimated Annual Monthly Deductibles: [?] and Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Drug Copay [?] / Restrictions [?] and Other Rating: [?]
[?] Coinsurance: [?] Programs:
Retail $19.10 Annual Drug Deductible: All Your Drugs on Formulary Coming Soon Enrollment begins
$365 :Yes October 15, 2018
Pharmacy Status:
Preferred Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $0 - $47, 25% - 40% Lower Your Drug Costs

Annual: $4,086 MTM Program : Yes

Mail Order
Annual: $4,245
Aetna Medicare Rx Value Plus (PDP) (S5768-155-0)
Organization: Aetna Medicare
Estimated Annual Monthly Deductibles: [?] and Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Drug Copay [?] / Restrictions [?] and Other Rating: [?]
[?] Coinsurance: [?] Programs:
Retail $58.70 Annual Drug Deductible: $0 All Your Drugs on Formulary Coming Soon Enrollment begins
:Yes October 15, 2018
Pharmacy Status: Drug Copay/ Coinsurance:
Preferred Cost- $1 - $47, 33% - 48% Drug Restrictions: Yes
Sharing Lower Your Drug Costs

Annual: $4,622 MTM Program : Yes

Mail Order
Annual: $4,749
Anthem Blue Cross MedicareRx Plus (PDP) (S5596-034-0)
Organization: Blue MedicareRx
Estimated Annual Monthly Deductibles: [?] and Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Drug Copay [?] / Restrictions [?] and Other Rating: [?]
[?] Coinsurance: [?] Programs:
Retail $113.10 Annual Drug Deductible: $0 All Your Drugs on Formulary Coming Soon Enrollment begins
:Yes October 15, 2018
Pharmacy Status: Drug Copay/ Coinsurance:
Preferred Cost- $0 - $40, 33% - 38% Drug Restrictions: Yes
Sharing Lower Your Drug Costs

Annual: $5,052 MTM Program : Yes

Mail Order
Annual: $4,886

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