Medicare Supplement Plans from Columbia Mutual

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Columbia Mutual Medicare Supplement Plan Information

Plan Brochure (PDF) | Application (PDF) | Medicare and You | Choose Medigap

Columbia Mutual Medicare Supplement Rates

Rates effective 08/2011	Plan A MTC 20	Plan F MTC 24	Plan G MTC 25
Male / 65yr / Non-tobacco / zip codes 970-972	$95.95	$134.62	$110.06
Female / 65yr / Non-tobacco / zip codes 970-972	$83.48	$117.12	$95.75
Male / 65yr / Tobacco / zip codes 970-972	$110.29	$154.73	$126.51
Female / 65yr / Tobacco / zip codes 970-972	$95.95	$134.62	$110.06
Male / 65yr / Non-tobacco / zip codes 973-979	$92.26	$129.44	$105.83
Female / 65yr / Non-tobacco / zip codes 973-979	$80.27	$112.61	$92.07
Male / 65yr / Tobacco / zip codes 973-979	$106.05	$148.78	$121.64
Female / 65yr / Tobacco / zip codes 973-979	$92.26	$129.44	$105.83
Benefits	Plan A	Plan F	Plan G
Medicare Part A Coinsurance and Hospital Benefits
Medicare Part A Deductible
Medicare Part B Coinsurance or Co-payment
Medicare Part B Deductible
Medicare Part B Excess Charges
Blood (First Three Pints)
Hospice Care Coinsurance or Co-payment
Skilled Nursing Coinsurance
Foreign Travel Emergency (Up to Plan Limits)³
Medicare Preventive Care Part B Coinsurance

Medigap Plan F offers a high deductible option. You must pay for Medicare-covered costs up to the high-deductible amount ($2,070 in 2012) before your Medigap policy pays anything
100% part B coinsurance except up to $20 copayment for office visits and up to $50 copayment for ER.
You must also pay a separate deductible for foreign travel emergency ($250 per year).
After you meet your out-of-pocket yearly limit and your yearly Part B deductible ($140 in 2012) the plan pays 100% of covered services for the rest of the calendar year (This applies only to plans K & L)
Modified Plan F offers an individual assistance program, as well as coverage for preventive dental care (available in some states)

2012 Out of Pocket Limit for Plan K is $4,660.
2012 Out of Pocket Limit for Plan L is $2,330.