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Important Links
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Eligibility
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HIPAA Eligibility
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Medical Conditions
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Summary of Benefits
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Plan Designs
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Monthly Premiums
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Qualifying Rates
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Premium Assistance
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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.
MEDICARE CARVEOUT (MC) PLAN 
FEMALE
       
    Low Income Premium Program
Female Medicare Carveout Federal Poverty Income Range:
Attained Age $500 Plan 0% to 199%  200% to 399% 
    75% Premium Reduction 50% Premium Reduction
       
0 - 18 $81 $20 $41
19 $126 $32 $63
20 $126 $32 $63
21 $126 $32 $63
22 $126 $32 $63
23 $126 $32 $63
24 $126 $32 $63
25 $132 $33 $66
26 $137 $34 $69
27 $143 $36 $72
28 $148 $37 $74
29 $152 $38 $76
30 $157 $39 $79
31 $162 $41 $81
32 $167 $42 $84
33 $173 $43 $87
34 $179 $45 $90
35 $186 $47 $93
36 $193 $48 $97
37 $200 $50 $100
38 $207 $52 $104
39 $214 $54 $107
40 $221 $55 $111
41 $228 $57 $114
42 $236 $59 $118
43 $243 $61 $122
44 $251 $63 $126
45 $259 $65 $130
46 $267 $67 $134
47 $275 $69 $138
48 $279 $70 $140
49 $284 $71 $142
50 $288 $72 $144
51 $293 $73 $147
52 $297 $74 $149
53 $299 $75 $150
54 $300 $75 $150
55 $302 $76 $151
56 $303 $76 $152
57 $305 $76 $153
58 $307 $77 $154
59 $309 $77 $155
60 $311 $78 $156
61 $314 $79 $157
62 $316 $79 $158
63 $326 $82 $163
64 $335 $84 $168


 

 
 
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