Page 70 - Evaluation for 2018

1/4/2018 Your Medicare Health Plan Details

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Your Plan Details

Zip Code: 99005
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: 1321108544
and more coverage and star ratings.
Password Date: 12/23/2017
Important Coverage Information

Symbols

Some Vision Coverage Some Hearing Coverage
* Estimated

AARP MedicareComplete 3315 Central AVE Overall Star Rating: [?] Enroll
Hot Springs, AR 71913
Plan 1 (HMO)
(H1286-002-0) Members: 4 out of 5 stars
1-800-643-4845
Organization: UnitedHealthcare 711 (TTY/TDD)

Plan Type: Non Members:
1-800-555-5757
711 (TTY/TDD)

Fixed Costs

Monthly Drug Plan Premium [?] $17.00

Monthly Health Plan Premium [?] $0.00

Annual Drug Deductible [?] $180.00

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 # $253.00
Walmart Pharmacy 10-2865 $253.00
Mail Order Pharmacy $187.00
Lower your drug costs

Estimated Full Cost the Plan Charges Medicare for Your Drugs

Drug Costs During Coverage Levels

https://www.medicare.gov/find-a-plan/results/planresults/plan-details.aspx?cntrctid=H1286&plnid=002&sgmntid=0 1/3