Areas & Rates (No Copay)
Area 1 Area 2 Area 3 Area 4 Area 5
MONTHLY NO CO-PAY PLAN RATES FOR RATING AREA I
Effective October 1st, 2018 the Administration Fee is included in the premiums listed below.
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| Plan Deductible | $0 | $100 | $150 | $250 | $500 | $750 | $1,000 | $1,500 | $2,000 | $2,500 | $3,000 | $4,000 |
| Age 65 | $171.35 | $159.85 | $153.16 | $145.17 | $128.31 | $115.05 | $103.68 | $85.76 | $72.15 | $62.42 | $55.64 | $47.52 |
| Age 66 | $185.24 | $172.67 | $165.37 | $156.68 | $138.25 | $123.76 | $111.34 | $91.79 | $76.94 | $66.32 | $58.90 | $50.05 |
| Age 67 | $191.03 | $178.03 | $170.46 | $161.46 | $142.39 | $127.40 | $114.55 | $94.30 | $78.94 | $67.95 | $60.27 | $51.10 |
| Age 68 | $196.70 | $183.27 | $175.45 | $166.15 | $146.45 | $130.95 | $117.68 | $96.77 | $80.88 | $69.54 | $61.61 | $52.13 |
| Age 69 | $202.22 | $188.37 | $180.32 | $170.73 | $150.41 | $134.42 | $120.73 | $99.18 | $82.80 | $71.08 | $62.90 | $53.13 |
| Age 70-74 | $234.12 | $220.40 | $211.98 | $202.28 | $181.16 | $164.12 | $149.32 | $125.38 | $106.61 | $92.68 | $82.61 | $69.62 |
| Age 75-79 | $270.41 | $256.14 | $247.17 | $236.94 | $214.25 | $195.61 | $179.14 | $152.13 | $130.52 | $114.09 | $101.94 | $85.61 |
| Age 80-84 | $323.44 | $308.29 | $298.47 | $287.11 | $261.78 | $240.64 | $221.80 | $190.26 | $164.44 | $144.34 | $129.22 | $108.08 |
| Age 85+ | $338.52 | $323.39 | $313.77 | $302.32 | $276.76 | $255.16 | $235.70 | $202.96 | $175.95 | $154.75 | $138.57 | $115.73 |
| OPTIONAL BENEFIT RATES | |
| Optional Benefit | Monthly Rate |
| Additional Skilled Nursing | $7.68 |
| Private Duty Nursing | $8.87 |
| At Home Recovery | $19.49 |
| Comprehensive Wellness | $14.18 |