Page 38 - Cover Letter and Evaluation for Anne Parlin

10/10/2017 Your Plan Results
Retail $26.00 Annual Drug Deductible: All Your Drugs on Formulary Coming Soon Enrollment begins
$405 :Yes October 15, 2017
Pharmacy Status:
Preferred Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $1 - $18, 25% - 47% Lower Your Drug Costs
Annual: $387 MTM Program : Yes
Mail Order
Annual: $726
SilverScript Choice (PDP) (S5601-010-0)
Organization: SilverScript
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $29.50 Annual Drug Deductible: $0 All Your Drugs on Formulary Coming Soon Enrollment begins
:Yes October 15, 2017
Pharmacy Status: Drug Copay/ Coinsurance:
Preferred Cost- $9 - $46, 33% - 49% Drug Restrictions: No
Sharing Lower Your Drug Costs
Annual: $550 MTM Program : Yes
Mail Order
Annual: $517
EnvisionRxPlus (PDP) (S7694-005-0)
Organization: EnvisionRx Plus
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $12.60 Annual Drug Deductible: All Your Drugs on Formulary Coming Soon Enrollment begins
$300 :Yes October 15, 2017
Pharmacy Status:
Preferred Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $1 - $29, 27% - 39% Lower Your Drug Costs
Annual: $573 MTM Program : Yes
Mail Order
Annual: $589
Humana Walmart Rx Plan (PDP) (S5884-151-0)
Organization: Humana Insurance Company
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $20.40 Annual Drug Deductible: All Your Drugs on Formulary Coming Soon Enrollment begins
$405 :Yes October 15, 2017
Pharmacy Status:
Standard Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $1 - $4, 23% - 35% Lower Your Drug Costs
Annual: $595 MTM Program : Yes
Mail Order
Annual: $540
Symphonix Value Rx (PDP) (S0522-006-0)
Organization: UnitedHealthcare
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $25.50 Annual Drug Deductible: All Your Drugs on Formulary Coming Soon Enrollment begins
$405 :Yes October 15, 2017
Pharmacy Status:
Preferred Cost- Drug Copay/ Coinsurance: Drug Restrictions: No
Sharing $1 - $35, 25% Lower Your Drug Costs
Annual: $678 MTM Program : Yes
Mail Order
Annual: $720
Magellan Rx Medicare Basic (PDP) (S4607-003-0)
Organization: Magellan Rx Medicare
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $31.10 Annual Drug Deductible: All Your Drugs on Formulary Coming Soon Enrollment begins
$405 :Yes October 15, 2017
Pharmacy Status:
Preferred Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $1 - $3, 11% - 50% Lower Your Drug Costs
Annual: $699 MTM Program : Yes
Mail Order
Annual: $599
WellCare Classic (PDP) (S4802-079-0)
Organization: WellCare
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:

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