Page 76 - Cover Letter and Evaluation for Mike Peaseley
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11/17/2017                                       Your Medicare Health Plan Details







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         Your Plan Details

                                                                          Zip Code:  98499
                                                                          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:  6951340928
         and more coverage and star ratings.
                                                                          Password Date:  11/16/2017
                                                                          Important Coverage Information


             Symbols

               A process through which the physician or other health care provider is required to obtain advance approval from the plan that payment
               will be made for a service or item furnished to an enrollee. Unless specified otherwise with respect to a particular item or service, the
               enrollee is not responsible for obtaining (prior) authorization.
               A process through which the enrollee’s primary care physician or other network physician (depending on the plan policy) permits or
               instructs the enrollee to obtain an item or service from another physician or other provider type.
              Some Vision Coverage          Some Hearing Coverage
           * Estimated





                                                                                 Enrollment phone
                                                                                 number

            Aetna Medicare Value Plan        P.O. Box 14088              Overall Star Rating:  [?]   Enroll
                                             Lexington, KY 40512
            (HMO)
                                                                         3.5 out of 5 stars
            (H3931-126-0) 1                  Members:
                                             1-800-282-5366
            Organization: Aetna Medicare     711 (TTY/TDD)
            Plan Type:                       Non Members:
                                             1-855-338-7027
                                             711 (TTY/TDD)


               Additional Plan Information


            Overall Star Rating   [?]
                                                                                              3.5 out of 5 stars


            Health Plan Star Ratings   [?]
                                                                                              3.5 out of 5 stars

                                                           Large provider
            Drug Plan Star Ratings   [?]                   network for an
                                                                                              3.5 out of 5 stars
                                                           HMO that serves
            Plan Type: HMO                                 three counties
            Plan Status: Approved by Medicare
            Area: King, Pierce and Snohomish counties

            View plan website 
            Important Note:

      https://www.medicare.gov/find-a-plan/results/planresults/plan-details.aspx?cntrctid=H3931&plnid=126&sgmntid=0  1/2
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