Page 50 - Cover Letter and Evaluation for Barbara Lesswing

11/20/2017 Your Plan Results
Retail $73.00 Annual Drug Doctor Choice: All Your Drugs on $7,040 Enroll
Deductible: Any Doctor Formulary :No
Pharmacy Drug: $37.80 $325 4.5 out of 5
Status: Health: Out of Pocket Drug Restrictions: stars
Standard Cost- $35.20 Health Plan Spending Yes
Sharing Deductible: $0 Limit: $10,000 Lower Your Drug
Part B Drug Copay/ In and Out-of- Costs
Annual: $2,936 Premium Coinsurance: $1 network
Reduction - $47, 25% - $6,700 In- MTM Program :
Mail Order :No 36% network Yes
Annual: $2,727

Notes:
Your costs may be different depending on your Part B premium, any Part D penalty that may apply, and whether you qualify for
Extra Help from Medicare paying your drug costs.

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