Page 72 - Cover Letter and Evaluation for Kirk Schmidt

10/31/2017 Your Plan Results

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Your Plan Results
Zip Code: 95076
Current Coverage: Original Medicare
Current Subsidy: No Extra Help [?]
Drug List ID: 5773524704
Your plan results are organized by plan type and are initially sorted by lowest Password Date: 10/22/2017
estimated cost. To view more plans, select View 20 or View All. Select any plan Important Coverage Information
name for details. Compare up to 3 plans by using the checkboxes and selecting
Compare Plans. The costs displayed are estimates; your actual costs may vary.

You are now viewing 2018 plan data. View 2017 plan data.

This is a list of the lowest-cost Part D
Symbols stand-alone plans in 2018 for the Rx
drugs that you take. The list is sorted by
Nationwide Coverage
the plans' estimated annual costs, with
the lowest-cost plan listed first. Costs
Your Current Plan(s) assume you will get Advair refills every
two months.
Original Medicare (H0001-001-0)
Includes Part A (Hospital Insurance) and/or Part B (Medical Insurance) - Excludes Part D Drug
Coverage
Estimated Monthly Deductibles: Health Benefits: [?] Drug Coverage [?] Estimated Overall Star
Annual Drug Premium: [?] and Drug , Drug Restrictions Annual Health Rating: [?]
Costs: [?] [?] Copay [?] / [?] and Drug Costs:
Coinsurance: [?]
[?]
Retail Standard Part B Doctor Choice: Any N/A $11,240 Not Available
Annual: $7,366 Part B: Deductible: $183 Willing Doctor Includes $7,366
$134 for drug costs
Out of Pocket Spending
Limit: Not Applicable

Prescription Drug Plans $892 estimated annual costs in
2018 if you get mail-order
25 plans were found in 95076 based on your search criteria. View 10 View 20 View All
refills. Costs include premiums
and co-pays (this plan does not
Sort Results By have a deductible).
SilverScript Choice (PDP) (S5601-064-0)
Organization: SilverScript
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $28.50 Annual Drug Deductible: $0 All Your Drugs on Enroll
Formulary :Yes
Pharmacy Status: Drug Copay/ Coinsurance: 4 out of 5 stars
Preferred Cost- $3 - $42, 33% - 46% Drug Restrictions: Yes
Sharing Lower Your Drug Costs
Annual: $1,038 MTM Program : Yes
Mail Order
Annual: $892
Humana Walmart Rx Plan (PDP) (S5884-178-0)
Organization: Humana Insurance Company

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