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Eligibility
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Summary of Benefits
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Monthly Premiums
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Qualifying Rates
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Medicare Carve-Out
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Application/Forms
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Important Notices
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Monthly Premiums: 
Regular Plan Medicare Carve Out Low Income Premium Program
Female
Male		 Female
Male		 50% Reduction Male
50% Reduction Female
75% Reduction Male
75% Reduction Female
All rates effective July 1, 2008 through December 31, 2008.
REGULAR PLAN LOW INCOME PREMIUM PROGRAM (LIPP)

FEMALE
50% PREMIUM REDUCTION
(Federal Poverty Income Range
200% to 399%) Monthly Premium Rates
 
 
Female 500 1000 2000 5000 7500 10000
Attained Age Plan Plan Plan Plan Plan Plan
             
 0 - 18 $65 $58 $49 $39 $34 $31
19 $102 $91 $77 $61 $54 $48
20 $102 $91 $77 $61 $54 $48
21 $102 $91 $77 $61 $54 $48
22 $102 $91 $77 $61 $54 $48
23 $102 $91 $77 $61 $54 $48
24 $102 $91 $77 $61 $54 $48
25 $107 $95 $80 $63 $56 $50
26 $111 $99 $84 $66 $59 $52
27 $116 $103 $87 $69 $61 $55
28 $120 $107 $90 $71 $63 $57
29 $123 $110 $93 $73 $65 $58
30 $127 $113 $96 $75 $67 $60
31 $130 $117 $98 $78 $69 $62
32 $135 $120 $101 $80 $70 $63
33 $140 $124 $105 $82 $74 $66
34 $145 $129 $109 $86 $76 $68
35 $150 $134 $113 $89 $79 $70
36 $156 $139 $117 $92 $82 $74
37 $161 $144 $122 $96 $85 $76
38 $166 $148 $126 $99 $87 $79
39 $172 $153 $130 $103 $91 $81
40 $178 $159 $134 $105 $93 $84
41 $184 $164 $139 $109 $97 $87
42 $190 $170 $143 $113 $100 $90
43 $196 $175 $148 $117 $104 $93
44 $202 $181 $153 $120 $106 $96
45 $209 $186 $158 $124 $110 $99
46 $215 $192 $162 $128 $114 $102
47 $222 $198 $168 $132 $117 $105
48 $226 $201 $170 $134 $119 $107
49 $229 $205 $173 $136 $121 $108
50 $233 $208 $176 $138 $123 $110
51 $236 $211 $178