Plan Overview | Enrollment form | Medicare and You | Choose

Rates effective 7/1/2011	Plan A	Plan B	Plan C	Plan F	High Ded Plan F	Plan K	Plan L	Plan N
Monthly Premiums Male - 65 years old Preferred Rating	$107.65	$116.98	$134.56	$137.27	$52.72	$63.96	$90.06	$85.40
Monthly Premiums Female - 65 years old Preferred Rating	$107.37	$116.68	$134.22	$136.93	$52.59	$63.80	$89.83	$85.19
Monthly Premiums Male - 65 years old Standard Rating	$159.90	$173.85	$200.14	$204.17	$77.82	$94.60	$133.62	$126.65
Monthly Premiums Female - 65 years old Standard Rating	$159.49	$173.41	$199.63	$203.67	$77.62	$94.36	$133.28	$126.33
Benefits	Plan A	Plan B	Plan C	Plan F	High Ded Plan F	Plan K	Plan L	Plan N
Medicare Part A Coinsurance and Hospital Benefits
Medicare Part A Deductible						50%	75%
Medicare Part B Coinsurance or Co-payment						50%	75%	3
Medicare Part B Deductible
Medicare Part B Excess Charges
Blood (First Three Pints)						50%	75%
Hospice Care Coinsurance or Co-payment						50%	75%
Skilled Nursing Coinsurance						50%	75%
Foreign Travel Emergency (Up to Plan Limits)3
Medicare Preventive Care Part B Coinsurance

Monthly premiums presented include $2 for coupon book billing method. If a policyholder elects either automatic bank withdrawal or recurring credit card transaction as a payment method, the premium is $2 less.