Medicare Supplement Plans - UnitedHealthcare MedicareRx for ...

Cover Page - Rates for California - Area 4
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 $80.65 $107.98 $126.28 $126.85 $51.39 $74.87 $84.11
66 $84.11 $112.61 $131.69 $132.29 $53.59 $78.08 $87.72
67 $87.56 $117.24 $137.10 $137.72 $55.79 $81.29 $91.32
68 $91.02 $121.87 $142.51 $143.16 $58.00 $84.50 $94.93
69 $94.48 $126.50 $147.92 $148.60 $60.20 $87.71 $98.53
70 $97.93 $131.12 $153.34 $154.03 $62.40 $90.92 $102.14
71 $101.39 $135.75 $158.75 $159.47 $64.60 $94.13 $105.74
72 $104.85 $140.38 $164.16 $164.91 $66.81 $97.34 $109.35
73 $108.30 $145.01 $169.57 $170.34 $69.01 $100.55 $112.95
74 $111.76 $149.64 $174.98 $175.78 $71.21 $103.76 $116.56
Standard Rates for ages 75 and older
75+ $115.22 $154.27 $180.40 $181.22 $73.42 $106.97 $120.17
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
$126.74 $169.69 $198.44 $199.34 $80.76 $117.66 $132.18
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
$144.02 $192.83 $225.50 $226.52 $91.77 $133.71 $150.21
The rates above are for plan effective dates from January - December 2011.
Appendix
MRP0003 CAD 1-11
California
This information applies for plan effective dates of January 1, 2011 - December 1, 2011 41