Page 136 - Cover Letter & Evaluation for Carol Evans

6/6/2018 Your Plan Results

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Your Plan Results
Zip Code: 85718
Current Coverage: Original Medicare
Current Subsidy: No Extra Help [?]
Important Coverage Information
Your plan results are organized by plan type and are initially sorted by lowest
estimated cost. To view more plans, select View 20 or View All. Select any plan
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.

This is a list of the 10 lowest-
Symbols
premium Part D stand-alone plans in
Nationwide Coverage your zip code. This list is sorted so
that the lowest-premium plans are
listed first.
Your Current Plan(s)

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 $3,890 Not Available
Annual: N/A Part B: Deductible: Willing Doctor
$134 $183
Out of Pocket
Spending Limit: Not
Applicable

Prescription Drug Plans

23 plans were found in 85718 based on your search criteria. View 10 View 20 View All

Sort Results By
Aetna Medicare Rx Select (PDP) (S5810-294-0)
Organization: Aetna Medicare
Estimated Annual Monthly Deductibles: [?] and Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Drug Copay [?] / Restrictions [?] and Rating: [?]
[?] Coinsurance: [?] Other Programs:
Retail $12.70 Annual Drug Deductible: All Your Drugs on Formulary Enroll
Annual: $152.40 $405 :N/A
3.5 out of 5
Mail Order Drug Copay/ Coinsurance: Drug Restrictions: N/A stars
Annual: N/A $0 - $47, 25% - 45%
MTM Program : Yes

Humana Walmart Rx Plan (PDP) (S5884-174-0)
Organization: Humana Insurance Company

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