Page 94 - Cover Letter and Evaluation for John

10/9/2018 Your Plan Results
Retail $169.80 Annual Drug Deductible: $0 All Your Drugs on Formulary Enroll
:Yes
Pharmacy Status: Drug Copay/ Coinsurance: 3.5 out of 5
Preferred Cost- $0 - $28, 33% - 35% Drug Restrictions: Yes stars
Sharing Lower Your Drug Costs

Cost as of Today: MTM Program : Yes This is the lowest-
$607
cost plan for your
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Cost as of Today: drugs next year
$757 (2019), but it is $200
AARP MedicareRx Walgreens (PDP) (S5921-413-0) more expensive than
Organization: UnitedHealthcare the lowest-cost plan
Estimated Annual Monthly Deductibles: [?] and Drug Coverage [?] , Drug Overall Star for the last two
Drug Costs: [?] Premium: Drug Copay [?] / Restrictions [?] and Other Rating: [?]
[?] Coinsurance: [?] Programs: months of this year.
Retail $26.80 Annual Drug Deductible: All Your Drugs on Formulary Enroll
$405 :Yes
Pharmacy Status: 3.5 out of 5
Preferred Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes stars
Sharing $0 - $31, 25% - 32% Lower Your Drug Costs

Cost as of Today: MTM Program : Yes
$632

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Cost as of Today:
$641
Cigna-HealthSpring Rx Secure (PDP) (S5617-158-0)
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 $86.90 Annual Drug Deductible: All Your Drugs on Formulary Enroll
$405 :Yes
Pharmacy Status: 2 out of 5 stars
Standard Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $1 - $34, 25% - 39% Lower Your Drug Costs

Cost as of Today: MTM Program : Yes
$795

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Cost as of Today:
$827
SilverScript Plus (PDP) (S5601-065-0)
Organization: SilverScript
Estimated Annual Monthly Deductibles: [?] and Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Drug Copay [?] / Restrictions [?] and Other Rating: [?]
[?] Coinsurance: [?] Programs:
Retail $79.70 Annual Drug Deductible: $0 All Your Drugs on Formulary Enroll
:Yes
Pharmacy Status: Drug Copay/ Coinsurance: 4 out of 5 stars
Preferred Cost- $1 - $35, 33% - 40% Drug Restrictions: Yes
Sharing Lower Your Drug Costs

Cost as of Today: MTM Program : Yes
$817

Mail Order
Cost as of Today:
$1,081
WellCare Extra (PDP) (S4802-128-0)
Organization: WellCare
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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