Page 14 - Cover Letter and Mediicae Evaluation for Mr. Bruno V. Manno

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
Not indicated
usually get the lowest prices at one of your plan's preferred
pharmacies. Some plans, though, do not have preferred
Not indicated
pharmacies.
Plan Name Preferred pharmacies

Clear Spring Health Premier Rx CVS and Walmart
Prescription Drug Plan (PDP)
Elixir RxPlus Prescription Drug Plan CVS and Walmart

No Medicare Advantage plans were compared in this evaluation

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The lowest-cost Part D stand-alone plans for your drugs

If you get a Medigap policy, you will also Clear Spring Health Premier Rx Elixir RxPlus Prescription Drug
need to enroll in a stand-alone drug Prescription Drug Plan (PDP) Plan
plan. To enroll, call the plan's toll-free
number (877) 317-6082 (888) 377-1439
Estimated annual costs for refills at a
CVS pharmacy $320 $434
Estimated annual costs for refills at a
Walgreens pharmacy $1,030 $1,074
Estimated annual costs for refills at a $320 $426
Walmart pharmacy
Est. annual costs for mail-order refills $320 $253

This plan is too new to be
This plan's Medicare quality rating 3.5 out of 5 stars
rated
Medicare Advantage plans' costs for your drugs

This Medicare Advantage plan includes
prescription drug and medical
coverage
No Medicare Advantage plans were compared in this
Est. annual costs for mail-order refills evaluation

Est. annual costs for monthly refills

This plan's Medicare quality rating

4