Page 134 - Cover Letter and Evaluation for Gary Janke

10/8/2018 Your Plan Results

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Your Plan Results
Zip Code: 37024
Current Coverage: Original Medicare
Current Subsidy: No Extra Help [?]
Drug List ID: 2912465408
Your plan results are organized by plan type and are initially sorted by lowest Password Date: 10/01/2018
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 2019 plan data. View 2018 plan data.

Symbols These are the 10 lowest-cost Part D
standalone plans for the Rx drugs that you
Nationwide Coverage
take. This list is sorted by the plans' costs
for your drugs if you get mail-order refills.
Your Current Plan(s) Costs include premiums, deductible, and
co-payments.
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 Annual Health Rating: [?]
Costs: [?] [?] Copay [?] / Restrictions [?] and Drug
Coinsurance: Costs: [?]
[?]
Retail Standard Part B Doctor Choice: Any N/A $23,410 Coming Soon
Annual: $19,521 Part B: Deductible: Willing Doctor Includes
$134 $183 $19,521 for
Out of Pocket drug costs
Spending Limit: Not
Applicable

Prescription Drug Plans

29 plans were found in 37024 based on your search criteria. View 10 View 20 View All

Sort Results By
$1,400 for 2019
WellCare Value Script (PDP) (S4802-147-0) includes premiums,
Organization: WellCare deductible, and co-
Estimated Annual Monthly Deductibles: [?] and Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Drug Copay [?] / Restrictions [?] and pays for your drugs.
Rating: [?]
[?] Coinsurance: [?] Other Programs:
Retail $15.50 Annual Drug Deductible: All Your Drugs on Formulary Coming Soon Enrollment begins
$415 :Yes October 15, 2018
Pharmacy Status:
Preferred Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $0 - $40, 25% - 46% Lower Your Drug Costs

Annual: $1,715 MTM Program : Yes

Mail Order
Annual: $1,400

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