Medicare Supplement Plans - UnitedHealthcare MedicareRx for ...

Appendix II
Cover Page - Rates for California - Area 1
Non-Tobacco Monthly Plan Rates
AARP ® Medicare Supplement Insurance Plans insured by UnitedHealthcare Insurance Company
Group 1
Applies to individuals whose plan effective date will be within six years
following their 65th birthday or Medicare Part B effective date, if later.
Age 1 Plan A Plan B Plan C Plan F Plan K Plan L Plan N
Standard Rates with Enrollment Discount 2 for individuals ages 65-74
65 $100.80 $134.92 $157.67 $158.37 $64.22 $93.62 $105.17
66 $105.12 $140.70 $164.43 $165.16 $66.97 $97.63 $109.68
67 $109.44 $146.49 $171.19 $171.95 $69.73 $101.65 $114.19
68 $113.76 $152.27 $177.94 $178.73 $72.48 $105.66 $118.69
69 $118.08 $158.05 $184.70 $185.52 $75.23 $109.67 $123.20
70 $122.40 $163.83 $191.46 $192.31 $77.98 $113.68 $127.71
71 $126.72 $169.62 $198.22 $199.10 $80.74 $117.70 $132.22
72 $131.04 $175.40 $204.97 $205.88 $83.49 $121.71 $136.72
73 $135.36 $181.18 $211.73 $212.67 $86.24 $125.72 $141.23
74 $139.68 $186.96 $218.49 $219.46 $88.99 $129.73 $145.74
Standard Rates for ages 75 and older
75+ $144.00 $192.75 $225.25 $226.25 $91.75 $133.75 $150.25
Group 2
Applies to individuals whose plan effective date will be between 6 years and less than
10 years following their 65th birthday or Medicare Part B effective date, if later.
Plan A Plan B Plan C Plan F Plan K Plan L Plan N
Level 1 Rates
$158.40 $212.02 $247.77 $248.87 $100.92 $147.12 $165.27
Group 3
Applies to individuals whose plan effective date will be 10 or more years
following their 65th birthday or Medicare Part B effective date, if later.
Plan A Plan B Plan C Plan F Plan K Plan L Plan N
Level 2 Rates
$180.00 $240.93 $281.56 $282.81 $114.68 $167.18 $187.81
The rates above are for plan effective dates from January - December 2011.
Appendix
MRP0003 CAA 1/11
California
This information applies for plan effective dates of January 1, 2011 - December 1, 2011 31