Page 73 - Cover letter and evaluation for Linda Hosier

11/15/2017 Your Plan Results
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $33.80 Annual Drug Deductible: All Your Drugs on Enroll
$405 Formulary :Yes
Pharmacy Status: 3.5 out of 5 stars
Standard Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $0 - $1, 20% - 35% Lower Your Drug Costs
Annual: $1,172 MTM Program : Yes
Mail Order
Annual: $894
Aetna Medicare Rx Saver (PDP) (S5810-066-0)
Organization: Aetna Medicare
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $31.60 Annual Drug Deductible: All Your Drugs on Enroll
$375 Formulary :Yes
Pharmacy Status: 3.5 out of 5 stars
Preferred Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $1 - $30, 25% - 35% Lower Your Drug Costs
Annual: $932 MTM Program : Yes
Mail Order
Annual: $929
Cigna-HealthSpring Rx Secure-Extra (PDP) (S5617-277-0)
Organization: Cigna-HealthSpring Rx
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $64.50 Annual Drug Deductible: $0 All Your Drugs on Enroll
Formulary :Yes
Pharmacy Status: Drug Copay/ Coinsurance: 2 out of 5 stars
Preferred Cost- $4 - $42, 33% - 50% Drug Restrictions: Yes
Sharing Lower Your Drug Costs
Annual: $1,062 MTM Program : Yes
Mail Order
Annual: $1,054
AARP MedicareRx Walgreens (PDP) (S5921-413-0)
Organization: UnitedHealthcare
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $26.80 Annual Drug Deductible: All Your Drugs on Enroll
$405 Formulary :No
Pharmacy Status: 3.5 out of 5 stars
Standard Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $0 - $31, 25% - 32% Lower Your Drug Costs

Annual: $1,624 MTM Program : Yes
Mail Order
Annual: $1,395
Blue Shield Rx Plus (PDP) (S2468-003-0)
Organization: Blue Shield of California
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $82.50 Annual Drug Deductible: All Your Drugs on Enroll
$405 Formulary :Yes
Pharmacy Status: 3 out of 5 stars
Preferred Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $2 - $31, 25% Lower Your Drug Costs
Annual: $1,461 MTM Program : Yes

Mail Order
Annual: $1,435

https://www.medicare.gov/find-a-plan/results/planresults/plan-list.aspx 2/4