Page 13 - Cover Letter and Evaluation for Mike Peaseley

Plans that appear to meet your criteria (cont'd)

Aetna Medicare Aetna Medicare
Plan name Medigap Plan G Medigap Plan N
Select PPO Plan Value HMO Plan

Toll-Free Number NA NA (855) 338-7027 (855) 338-7027

Estimated annual premiums for medical coverage
lity ratings from Medicare web site (best rating = 5 stars)
2018 standard Part B

premium of $134 a $1,608 $1,608 $1,608 $1,608
month*

Health plan annual
premiums (Medigap $2,440 $1,950 $714 $0
premiums are estimates)

Total $4,048 $3,558 $2,322 $1,608

Minimum costs for Medicare-covered services

Total medical premiums $4,048 $3,558 $2,322 $1,608

(from above)
Plan health deductible

(includes Part B deductible if $183 $183 $0 $0
not covered by plan**)

Estimated annual Rx
costs, monthly refills $1,245 $1,245 $1,153 $835

Total Minimum Costs
(includes cost-sharing for the $5,476 $4,986 $3,475 $2,443
Rx drugs you now take)
Cost-sharing for doctors office visits

=
In-Network Primary
Care Co-Pays $15 $10
No co-pays for You pay 5% of
In-Network Specialist Medicare-covered Medicare approved
Co-Pays services amount $50 $45
Out-of-Network
Co-Pays Up to 45% of cost Not covered

*This is 2018 standard Part B premium for new enrollees who are not yet receiving Social Security benefits.
**Part B deductible in 2017 is $183.

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