Page 140 - Cover Letter & Evaluation for Carol Evans

6/6/2018 Your Medicare Health Plan Details

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Your Plan Details
Zip Code: 85718
Current Coverage: Original Medicare
Current Subsidy: No Extra Help [?]
Select the tabs below for more detailed information about the plan health benefits,
drug costs and more coverage and star ratings. Important Coverage Information

Symbols
Nationwide Coverage

* Estimated

Aetna Medicare Rx Select P.O. Box 14088 Overall Star Rating: [?] Enroll
Lexington, KY 40512
(PDP)
(S5810-294-0) Members: 3.5 out of 5 stars
1-877-238-6211
Organization: Aetna Medicare 711 (TTY/TDD)

Plan Type: PDP Non Members:
1-855-338-7030
711 (TTY/TDD) monthly premium

NOTE: Health Plan Benefits are based on Original Medicare

Fixed Costs

Monthly Health Plan Premium: Not Applicable
Monthly Drug Plan Premium: $12.70

Estimated Costs

You have not entered any drugs. The estimate below includes only the cost of the monthly premiums that you would pay for the
plan. To get specific costs for the drugs you take, Enter drugs.
Estimated annual drug costs: [?] $152.40

This does not include any health costs you may have.

Medicare costs at a glance

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