Page 48 - Cover Letter and Evaluation for Barbara Lesswing

11/20/2017 Your Plan Results
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall Star
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Rating: [?]
Costs: [?] [?] Copay [?] / Restrictions [?] Health and
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $105.00 Annual Drug Doctor Choice: All Your Drugs on $6,050 Enroll
Deductible: $0 Any Doctor Formulary :No
Pharmacy Drug: $52.60 4 out of 5
Status: Health: Health Plan Out of Pocket Drug Restrictions: stars
Preferred Cost- $52.40 Deductible: $0 Spending Yes
Sharing Drug Copay/ Limit: $3,400 Lower Your Drug
Part B Coinsurance: $0 In and Out-of- Costs
Annual: $2,637 Premium - $75, 33% network
Reduction $3,400 In- MTM Program :
Mail Order :No network Yes
Annual: $2,356

Today's Options Premier Plus 250A (PFFS) (H2816-013-0)
Organization: Universal American, A WellCare Company
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall Star
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Rating: [?]
Costs: [?] [?] Copay [?] / Restrictions [?] Health and
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $123.00 Annual Drug Doctor Choice: All Your Drugs on $6,480 Enroll
Deductible: $0 Plan Doctors Formulary :No
Pharmacy Drug: $56.00 for Most 3.5 out of 5
Status: Health: Health Plan Services Drug Restrictions: stars
Preferred Cost- $67.00 Deductible: $0 Yes
Sharing Drug Copay/ Out of Pocket Lower Your Drug
Part B Coinsurance: $0 Spending Costs
Annual: $2,678 Premium - $75, 33% Limit: $3,400
Reduction In and Out-of- MTM Program :
Mail Order :No network Yes
Annual: $2,397

Preferred Gold with Part D (HMO-POS) (H3305-015-0)
Organization: MVP HEALTH CARE
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall Star
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Rating: [?]
Costs: [?] [?] Copay [?] / Restrictions [?] Health and
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $197.00 Annual Drug Doctor Choice: All Your Drugs on $7,790 Enroll
Deductible: $0 Plan Doctors Formulary :No
Pharmacy Drug: $60.60 Only (some 4.5 out of 5
Status: Health: Health Plan exceptions) Drug Restrictions: stars
Standard Cost- $136.40 Deductible: $0 Yes
Sharing Drug Copay/ Out of Pocket Lower Your Drug
Part B Coinsurance: $0 Spending Costs
Annual: $2,779 Premium - $40, 33% - Limit: $6,700
Reduction 36% In-network MTM Program :
Mail Order :No Yes
Annual: $2,587
UnitedHealthcare MedicareComplete Choice Plan 4 (Regional PPO)
(R5342-006-0)
Organization: UnitedHealthcare
Estimated Monthly Deductibles Health Drug Coverage Estimated Overall Star
Annual Drug Premium: [?] and Drug Benefits: [?] [?] , Drug Annual Rating: [?]
Costs: [?] [?] Copay [?] / Restrictions [?] Health and
Coinsurance: and Other Drug
[?] Programs: Costs: [?]
Retail $77.00 Annual Drug Doctor Choice: All Your Drugs on $6,420 Enroll
Deductible: Any Doctor Formulary :No
Pharmacy Drug: $35.70 $100 3.5 out of 5
Status: Health: Out of Pocket Drug Restrictions: stars
Standard Cost- $41.30 Health Plan Spending Yes
Sharing Deductible: $0 Limit: $10,000 Lower Your Drug
Part B Drug Copay/ In and Out-of- Costs
Annual: $2,790 Premium Coinsurance: $3 network
Reduction - $100, 31% $5,400 In- MTM Program :
Mail Order :No network Yes
Annual: $2,480

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