Page 118 - Cover Letter and Evaluation for Anne Ellzey

11/8/2017 Your Medicare Health Plan Details

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Your Plan Details

Zip Code: 78704
Current Coverage: Original Medicare
Current Subsidy: No Extra Help [?]
Select the tabs below for more detailed information about the plan health benefits, drug costs Drug List ID: 3608244448
and more coverage and star ratings.
Password Date: 11/08/2017
Important Coverage Information

You are now viewing 2018 plan data. View 2017 plan data.
Symbols

Nationwide Coverage
* Estimated

Aetna Medicare Rx Saver P.O. Box 14088 Overall Star Rating: [?] Enroll
Lexington, KY 40512
(PDP)
(S5810-056-0) Members: 3.5 out of 5 stars
1-877-238-6211
Organization: Aetna Medicare 711 (TTY/TDD)
Plan Type: Non Members:
1-855-338-7030
711 (TTY/TDD)
Est. 2018 costs
include premiums,
NOTE: Health Plan Benefits are based on Original Medicare
deductible, and co-
payments.
Fixed Costs

Monthly Drug Plan Premium [?] $24.40

Monthly Health Plan Premium [?] N/A

Annual Drug Deductible [?] $375.00

Medicare costs at a glance
Estimate of What YOU Will Pay for Drug Plan Premium and Drug Costs

Full Year Cost (based on January enrollment) [?]
HEB Pharmacy $4,217.13
CVS Pharmacy $4,228.03
Mail Order Pharmacy $4,401.12
Lower your drug costs

Estimated Full Cost the Plan Charges Medicare for Your Drugs

https://www.medicare.gov/find-a-plan/results/planresults/plan-details.aspx?cntrctid=S5810&plnid=056&sgmntid=0 1/4