Areas & Rates (No Copay)
Area 1 Area 2 Area 3 Area 4 Area 5
MONTHLY NO CO-PAY PLAN RATES FOR RATING AREA V
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 | $247.03 | $229.76 | $219.73 | $207.76 | $182.46 | $162.56 | $145.53 | $118.63 | $98.21 | $83.64 | $73.45 | $61.29 |
| Age 66 | $267.85 | $249.02 | $238.06 | $224.99 | $197.37 | $175.65 | $157.02 | $127.69 | $105.39 | $89.47 | $78.36 | $65.07 |
| Age 67 | $276.55 | $257.04 | $245.70 | $232.18 | $203.60 | $181.10 | $161.84 | $131.47 | $108.39 | $91.92 | $80.41 | $66.65 |
| Age 68 | $285.04 | $264.89 | $253.19 | $239.22 | $209.66 | $186.43 | $166.53 | $135.16 | $111.31 | $94.31 | $82.41 | $68.19 |
| Age 69 | $293.33 | $272.55 | $260.47 | $246.06 | $215.61 | $191.64 | $171.12 | $138.77 | $114.17 | $96.63 | $84.37 | $69.71 |
| Age 70-74 | $341.19 | $320.58 | $307.98 | $293.42 | $261.72 | $236.18 | $213.97 | $178.07 | $149.91 | $129.02 | $113.91 | $94.42 |
| Age 75-79 | $395.61 | $374.21 | $360.77 | $345.42 | $311.36 | $283.41 | $258.73 | $218.21 | $185.79 | $161.12 | $142.92 | $118.43 |
| Age 80-84 | $475.15 | $452.42 | $437.72 | $420.67 | $382.66 | $350.95 | $322.70 | $275.39 | $236.67 | $206.51 | $183.82 | $152.13 |
| Age 85+ | $497.79 | $475.08 | $460.63 | $443.46 | $405.11 | $372.73 | $343.52 | $294.42 | $253.92 | $222.10 | $197.87 | $163.62 |
| OPTIONAL BENEFIT RATES | |
| Optional Benefit | Monthly Rate |
| Additional Skilled Nursing | $7.68 |
| Private Duty Nursing | $8.87 |
| At Home Recovery | $19.19 |
| Comprehensive Wellness | $14.18 |