Page 40 - Cover Letter and Evaluation for Anne Parlin

10/10/2017 Your Plan Results
Retail $35.00 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 - $21, 25% - 48% Lower Your Drug Costs
Annual: $495 MTM Program : Yes
Mail Order
Annual: $834
Humana Walmart Rx Plan (PDP) (S5552-005-0)
Organization: Humana Insurance Company of New York
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, 25% - 35% Lower Your Drug Costs
Annual: $604 MTM Program : Yes
Mail Order
Annual: $540
EnvisionRxPlus (PDP) (S7694-003-0)
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:
Standard Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $1 - $29, 27% - 38% Lower Your Drug Costs
Annual: $627 MTM Program : Yes
Mail Order
Annual: $589
SilverScript Choice (PDP) (S5601-006-0)
Organization: SilverScript
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $29.80 Annual Drug Deductible: $0 All Your Drugs on Formulary Coming Soon Enrollment begins
:Yes October 15, 2017
Pharmacy Status: Drug Copay/ Coinsurance:
Standard Cost- $3 - $40, 33% - 44% Drug Restrictions: No
Sharing Lower Your Drug Costs
Annual: $703 MTM Program : Yes
Mail Order
Annual: $579
Humana Preferred Rx Plan (PDP) (S5552-004-0)
Organization: Humana Insurance Company of New York
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $38.60 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 $0 - $1, 20% - 35% Lower Your Drug Costs
Annual: $823 MTM Program : Yes
Mail Order
Annual: $778
WellCare Classic (PDP) (S4802-077-0)
Organization: WellCare
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $38.10 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 $0 - $37, 25% - 48% Lower Your Drug Costs
Annual: $832 MTM Program : Yes
Mail Order
Annual: $667
Magellan Rx Medicare Basic (PDP) (S4607-002-0)
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:

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