Page 151 - Cover Letter and Evaluation for Gary Janke
P. 151

10/8/2018                                          Your Medicare Health Plan Details

            Provider Network:               18001-19000 physicians and providers.
                                            View provider and physician network website 
            View a chart on how an independent sales agent or broker would be compensated if they were to enroll you in a plan for 2019.


               Costs

            Monthly Premiums


                       2
            Part B premium                                                                    $134.00
            View Part B premiums based on income
            Plan premium                                                                      $0.00

                Health plan premium                                                           $0.00


                Drug plan premium                                                             $0.00
            Estimated Costs


            *Inpatient care                                                                   $24.00

            *Outpatient prescription drugs                                                    $95.59

            *Dental services                                                                  $28.00

            *All other services
                                                                                              $106.00
            Total monthly estimated costs
                                                                                              $387.59

                                         3
            TOTAL ESTIMATED ANNUAL COSTS    [?]                                               $4,650

            How are Out-of-Pocket costs calculated?

            View estimated monthly Out-of-Pocket Costs (OOPC) for people with High-Cost Conditions (chronic care and unexpected illnesses)

            1 An out-of-pocket cost maximum applies for some services covered by this plan.
            2 Medicare costs at a glance
            3 Estimated Annual Costs are rounded to the nearest $10. They don't include any Medicare Part D (prescription drug) late enrollment
             penalty amounts that may apply to you. Also, if you have limited income and resources, your expenses may be lower.








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