| Rates effective 5/1/2011 |
Plan A |
Plan B |
Plan C |
Plan D |
Plan F |
Plan G |
Plan N |
| Male / 65yr / Non-tobacco |
$92.62 |
$100.55 |
$124.79 |
$107.08 |
$132.15 |
$108.08 |
$89.34 |
| Female / 65yr / Non-tobacco |
$80.58 |
$87.48 |
$108.57 |
$93.16 |
$114.97 |
$93.97 |
$77.72 |
| Male / 65yr / Tobacco |
$115.78 |
$125.69 |
$155.99 |
$133.85 |
$165.19 |
$135.02 |
$111.67 |
| Female / 65yr / Tobacco |
$100.73 |
$109.35 |
$135.71 |
$116.45 |
$143.72 |
$117.47 |
$97.15 |
| Benefits |
Plan A |
Plan B |
Plan C |
Plan D |
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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| Medicare Part B Coinsurance or Co-payment |
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3 |
| 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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| Hospice Care Coinsurance or Co-payment |
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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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Woodman of the World can only raise your premium if we raise the premium for all policies like yours in the same geographic area of the state where you live. This change can be made on
any renewal date. Schedules of rates may vary depending upon your Policy Date.
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