Page 14 - Cover Letter and Evaluation for Gary Janke

Your Prescription Drug Costs

These costs are for your prescription drugs and are based on the dosages and monthly quantities that
you use. These costs include premiums, deductible, and co-payments.

Pharmacy Information

When you need a retail prescription filled or refilled, you will
Mail-order refills
usually get the lowest prices at one of your plan's preferred
pharmacies. Some plans, though, do not have preferred
Walgreens
pharmacies.
Is UC Health a preferred pharmacy in the following plans' networks

Wellcare Value Script Prescription Drug CVS is a preferred pharmacy in this plan
Plan
Walmart and Sam's Club are this plan's only preferred
Wellcare Classic Prescription Drug Plan
pharmacies

Walgreens, Costco, Kroger, and Inception are all preferred
Blue Advantage Garnet PPO Plan
pharmacies in this plan

Walgreens, Costco, Kroger, and Inception are all preferred
Blue Advantage Ruby PPO Plan pharmacies in this plan
y g
The two lowest-cost Part D stand-alone plans for your drugs in 2019

Wellcare Value Script Wellcare Classic Prescription
Prescription Drug Plan Drug Plan
To enroll in a plan, call its toll-free
number (888) 293-5151 (888) 293-5151
Est. annual costs for monthly refills $1,715 $1,847

Est. annual costs with mail-order refills $1,400 $1,535

This plan's Medicare quality rating 2.5 stars in 2018 2.5 stars in 2018

Medicare Advantage plans' costs for your drugs in 2019

These two Medicare Advantage plans Blue Advantage Garnet PPO
include prescription drug and medical Plan Blue Advantage Ruby PPO Plan
coverage

Est. annual costs with monthly refills $1,447 $1,690

Est. annual costs with mail-order refills $903 $1,480

This plan's Medicare quality rating 4 stars in 2018 4 stars in 2018

4