United Commercial Travelers of America (UCT) Medicare Supplement Rates
| Annual Rates effective 6/1/2010 |
Plan A |
Plan F |
Plan G |
Plan N |
| Male / 65yr / Non-tobacco / zip codes 970-972 |
$1,545.05 |
$2,263.22 |
$1,884.37 |
$1,584.25 |
| Female / 65yr / Non-tobacco / zip codes 970-972 |
$1,344.09 |
$1,966.73 |
$1,638.94 |
$1,376.71 |
| Male / 65yr / Tobacco / zip codes 970-972 |
$1,932.14 |
$2,828.20 |
$2,357.11 |
$1,979.74 |
| Female / 65yr / Tobacco / zip codes 970-972 |
$1,680.12 |
$2,459.23 |
$2,049.09 |
$1,721.46 |
| Male / 65yr / Non-tobacco / zip codes 973-979 |
$1,358.90 |
$1,990.54 |
$1,657.34 |
$1,393.38 |
| Female / 65yr / Non-tobacco / zip codes 973-979 |
$1,182.15 |
$1,729.77 |
$1,441.48 |
$1,210.84 |
| Male / 65yr / Tobacco / zip codes 973-979 |
$1,699.35 |
$2,487.45 |
$2,073.12 |
$1,741.22 |
| Female / 65yr / Tobacco / zip codes 973-979 |
$1,477.70 |
$2,162.94 |
$1,802.21 |
$1,514.06 |
| Benefits |
Plan A |
Plan F |
Plan G |
Plan N |
| Medicare Part A Coinsurance and Hospital Benefits |
 |
|
|
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| Medicare Part A Deductible |
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|
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| Medicare Part B Coinsurance or Co-payment |
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|
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2 |
| Medicare Part B Deductible |
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|
|
|
| Medicare Part B Excess Charges |
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|
|
| Blood (First Three Pints) |
|
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|
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| Hospice Care Coinsurance or Co-payment |
|
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|
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| Skilled Nursing Coinsurance |
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| Foreign Travel Emergency (Up to Plan Limits)3 |
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| Medicare Preventive Care Part B Coinsurance |
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MODAL FACTORS: Semi-Annual – 0.51500 / Quarterly – 0.26250 / Direct Monthly – 0.10000 / Monthly EFT – 0.08333 |
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