Page 42 - Cover Letter and Evaluation for Anne Parlin

10/10/2017 Your Plan Results
Retail $33.40 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% - 40% Lower Your Drug Costs
Annual: $476 MTM Program : Yes
Mail Order
Annual: $815
EnvisionRxPlus (PDP) (S7694-002-0)
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% - 38% Lower Your Drug Costs
Annual: $573 MTM Program : Yes
Mail Order
Annual: $589
Humana Walmart Rx Plan (PDP) (S5884-149-0)
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, 21% - 35% Lower Your Drug Costs
Annual: $595 MTM Program : Yes
Mail Order
Annual: $540
SilverScript Choice (PDP) (S5601-004-0)
Organization: SilverScript
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $29.40 Annual Drug Deductible: $0 All Your Drugs on Formulary Coming Soon Enrollment begins
:Yes October 15, 2017
Pharmacy Status: Drug Copay/ Coinsurance:
Preferred Cost- $3 - $38, 33% - 38% Drug Restrictions: No
Sharing Lower Your Drug Costs
Annual: $613 MTM Program : Yes
Mail Order
Annual: $574
Blue MedicareRx Value Plus (PDP) (S2893-001-0)
Organization: Blue MedicareRx
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $38.20 Annual Drug Deductible: All Your Drugs on Formulary Coming Soon Enrollment begins
$235 :Yes October 15, 2017
Pharmacy Status:
Preferred Cost- Drug Copay/ Coinsurance: Drug Restrictions: Yes
Sharing $2 - $35, 28% - 40% Lower Your Drug Costs
Annual: $683 MTM Program : Yes
Mail Order
Annual: $661
Symphonix Value Rx (PDP) (S0522-079-0)
Organization: UnitedHealthcare
Estimated Annual Monthly Deductibles: [?] and Drug Drug Coverage [?] , Drug Overall Star
Drug Costs: [?] Premium: Copay [?] / Coinsurance: Restrictions [?] and Other Rating: [?]
[?] [?] Programs:
Retail $30.70 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 - $34, 25% - 26% Lower Your Drug Costs
Annual: $740 MTM Program : Yes
Mail Order
Annual: $782
WellCare Classic (PDP) (S4802-076-0)
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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