Page 93 - Cover Letter and Evaluation for John

10/9/2018 Your Plan Results
Retail $111.30 Annual Drug Deductible: $0 All Your Drugs on Formulary Enroll
:Yes
Pharmacy Status: Drug Copay/ Coinsurance: 3 out of 5 stars
These are the costs
Preferred Cost- $4 - $40, 25% - 33% Drug Restrictions: Yes
Sharing Lower Your Drug Costs for the last two

Cost as of Today: MTM Program : Yes months of 2018 for
$432 your Rx drugs. Costs

Mail Order include premiums,
Cost as of Today: deductible, and co-
$479
AARP MedicareRx Preferred (PDP) (S5820-031-0) payments.
Organization: UnitedHealthcare
Estimated Annual Monthly Deductibles: [?] and Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Drug Copay [?] / Restrictions [?] and Other Rating: [?]
[?] Coinsurance: [?] Programs:
Retail $94.50 Annual Drug Deductible: $0 All Your Drugs on Formulary Enroll
:Yes
Pharmacy Status: Drug Copay/ Coinsurance: 4 out of 5 stars
Preferred Cost- $6 - $37, 33% - 37% Drug Restrictions: Yes
Sharing Lower Your Drug Costs

Cost as of Today: MTM Program : Yes
$466

Mail Order
Cost as of Today:
$518
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 Enroll
:Yes
Pharmacy Status: Drug Copay/ Coinsurance: 3.5 out of 5
Preferred Cost- $3 - $42, 33% - 44% Drug Restrictions: Yes stars
Sharing Lower Your Drug Costs

Cost as of Today: MTM Program : Yes
$469

Mail Order
Cost as of Today:
$537
Cigna-HealthSpring Rx Secure-Extra (PDP) (S5617-277-0)
Organization: Cigna-HealthSpring Rx
Estimated Annual Monthly Deductibles: [?] and Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Drug Copay [?] / Restrictions [?] and Other Rating: [?]
[?] Coinsurance: [?] Programs:
Retail $64.50 Annual Drug Deductible: $0 All Your Drugs on Formulary Enroll
:Yes
Pharmacy Status: Drug Copay/ Coinsurance: 2 out of 5 stars
Standard Cost- $4 - $42, 33% - 50% Drug Restrictions: Yes
Sharing Lower Your Drug Costs

Cost as of Today: MTM Program : Yes
$512

Mail Order
Cost as of Today:
$734
Anthem Blue Cross MedicareRx Gold (PDP) (S5596-035-0)
Organization: Blue MedicareRx
Estimated Annual Monthly Deductibles: [?] and Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Drug Copay [?] / Restrictions [?] and Other Rating: [?]
[?] Coinsurance: [?] Programs:

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