Page 96 - Cover Letter and Evaluation for John

10/9/2018 Your Medicare Health Plan Details

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Your Plan Details

Zip Code: 92586
Current Coverage: Original Medicare
Current Subsidy: No Extra Help [?]
Select the tabs below for more detailed information about the plan health benefits, drug costs Drug List ID: 3199691584
and more coverage and star ratings. Password Date: 10/09/2018

Important Coverage Information

You are now viewing 2018 plan data. View 2019 plan data.

Symbols
* Estimated

Call this number to
enroll.

Blue Shield Rx Enhanced 6300 Canoga Avenue Overall Star Rating: [?] Enroll
Woodland Hills, CA 91367
(PDP)
(S2468-004-0) Members: 3 out of 5 stars
1-888-239-6469
Organization: Blue Shield of California 711 (TTY/TDD)

Plan Type: PDP Non Members:
1-800-488-8000
711 (TTY/TDD)
NOTE: Health Plan Benefits are based on Original Medicare

In this plan you will
Fixed Costs
get the lowest prices
at a CVS Pharmacy.
Monthly Drug Plan Premium [?] $111.30

Monthly Health Plan Premium [?] N/A

Annual Drug Deductible [?] $0.00
Medicare costs at a glance

Estimate of What YOU Will Pay for Drug Plan Premium and Drug Costs

Cost For Rest of Year (based on enrollment today) [?]
CVS Pharmacy #10434 $432.18
Walgreens $459.28
Mail Order Pharmacy $479.29
Lower your drug costs

Estimated Full Cost the Plan Charges Medicare for Your Drugs

Drug Costs During Coverage Levels

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