Important Links Eligibility HIPAA Eligibility Medical Conditions Summary of Benefits Plan Designs Monthly Premiums Qualifying Rates Premium Assistance Medicare Carve-Out Application/Forms Important Notices		Monthly Premiums:  NEW MEXICO MEDICAL INSURANCE POOL MEDICARE CARVEOUT (MC) PLAN PREMIUM RATES (Monthly) Effective January 1, 2010 through June 30, 2010                       Low Income Premium Program   All Members All Members Members Effective Prior To 1/1/2009 Members Effective On Or After 1/1/2009       Attained MC 500 Federal Poverty Income Range: Age Plan  0% to 199%  200% to 299%  300% to 399%  300% to 399%  Male             0 - 18 $88 $22 $44 $57 $66 19 $117 $29 $59 $76 $88 20 $117 $29 $59 $76 $88 21 $117 $29 $59 $76 $88 22 $117 $29 $59 $76 $88 23 $117 $29 $59 $76 $88 24 $117 $29 $59 $76 $88 25 $122 $31 $61 $79 $92 26 $126 $32 $63 $82 $95 27 $131 $33 $66 $85 $98 28 $135 $34 $68 $88 $101 29 $139 $35 $70 $90 $104 30 $143 $36 $72 $93 $107 31 $147 $37 $74 $96 $110 32 $151 $38 $76 $98 $113 33 $157 $39 $79 $102 $118 34 $162 $41 $81 $105 $122 35 $169 $42 $85 $110 $127 36 $175 $44 $88 $114 $131 37 $181 $45 $91 $118 $136 38 $187 $47 $94 $122 $140 39 $193 $48 $97 $125 $145 40 $200 $50 $100 $130 $150 41 $207 $52 $104 $135 $155 42 $214 $54 $107 $139 $161 43 $221 $55 $111 $144 $166 44 $228 $57 $114 $148 $171 45 $235 $59 $118 $153 $176 46 $242 $61 $121 $157 $182 47 $250 $63 $125 $163 $188 48 $258 $65 $129 $168 $194 49 $266 $67 $133 $173 $200 50 $274 $69 $137 $178 $206 51 $283 $71 $142 $184 $212 52 $291 $73 $146 $189 $218 53 $299 $75 $150 $194 $224 54 $307 $77 $154 $200 $230 55 $314 $79 $157 $204 $236 56 $322 $81 $161 $209 $242 57 $331 $83 $166 $215 $248 58 $333 $83 $167 $216 $250 59 $335 $84 $168 $218 $251 60 $338 $85 $169 $220 $254 61 $340 $85 $170 $221 $255 62 $343 $86 $172 $223 $257 63 $354 $89 $177 $230 $266 64 $365 $91 $183 $237 $274 Female             0 - 18 $88 $22 $44 $57 $66 19 $137 $34 $69 $89 $103 20 $137 $34 $69 $89 $103 21 $137 $34 $69 $89 $103 22 $137 $34 $69 $89 $103 23 $138 $35 $69 $90 $104 24 $138 $35 $69 $90 $104 25 $143 $36 $72 $93 $107 26 $149 $37 $75 $97 $112 27 $156 $39 $78 $101 $117 28 $161 $40 $81 $105 $121 29 $166 $42 $83 $108 $125 30 $171 $43 $86 $111 $128 31 $176 $44 $88 $114 $132 32 $182 $46 $91 $118 $137 33 $188 $47 $94 $122 $141 34 $195 $49 $98 $127 $146 35 $202 $51 $101 $131 $152 36 $210 $53 $105 $137 $158 37 $218 $55 $109 $142 $164 38 $224 $56 $112 $146 $168 39 $233 $58 $117 $151 $175 40 $240 $60 $120 $156 $180 41 $248 $62 $124 $161 $186 42 $256 $64 $128 $166 $192 43 $264 $66 $132 $172 $198 44 $272 $68 $136 $177 $204 45 $281 $70 $141 $183 $211 46 $290 $73 $145 $189 $218 47 $299 $75 $150 $194 $224 48 $303 $76 $152 $197 $227 49 $308 $77 $154 $200 $231 50 $313 $78 $157 $203 $235 51 $317 $79 $159 $206 $238 52 $322 $81 $161 $209 $242 53 $324 $81 $162 $211 $243 54 $326 $82 $163 $212 $245 55 $327 $82 $164 $213 $245 56 $329 $82 $165 $214 $247 57 $331 $83 $166 $215 $248 58 $333 $83 $167 $216 $250 59 $335 $84 $168 $218 $251 60 $338 $85 $169 $220 $254 61 $340 $85 $170 $221 $255 62 $343 $86 $172 $223 $257 63 $353 $88 $177 $229 $265 64 $364 $91 $182 $237 $273

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