Companies Rates and Useful InformationPublished by the New Hampshire Isuranepartment Rates quoted within this guide are available during nitial pen nrollmentor guaranteed issue periods Quoted rates ID: 944015
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ew Hampshire’s Guide Medicare Supplement Insurance Companies, Rates and Useful InformationPublished by the New Hampshire Isuranepartment Rates quoted within this guide are available during nitial pen nrollmentor guaranteed issue periods. Quoted rates are generallyavailable to individuals who are renewing coveragewith the specified company Individuals who are changing plans or who would like to obtain a renewal rate with a specific companyshould contact the company directly. to view the updated brochure.YoumayalsocontactNHInsurance Department’s ConsumerServices Division 1- - 852 - (option 20 2 1 MEDICARE SUPPLEMENT (MEDIGAP) CONSUMER TIPS Understand the insurance coverage you are buyingMedicare Supplement Insurance (also known as MedSupp and Medigap) is different than Medicare (Part A/B), Medicare Advantage and Medicare Part D.A Medicare Supplement Insurance policy helps pay some of the health care costs that original Medicare doesn’t cover, such as copayments, coinsurance and deductibles.For additional information about all types of Medicare coverage policies, including enrollment periods, please visit Medicare.gov, speak with a local agentor contact a statecertified, Medicare ounselor at ServiceLink (). Shop carefully before you buyCompare benefits, services and costs. Insurance companies may charge different premiums for exactly the same Medigap coverage. As you shop, be certain you are comparing the same Medigap plan.Read your policy to understand coverage and coverage limitationsKnow how your policy coordinates with any other coverage(s) you may have.Make sure that all the information on your application is correctAn incorrect application may cause the insurance company to cancel your policy or leave you with unpaid claims.Do not be misled by agents who tell you your health history does not matter.Describe your health status completely and accurately.It is best, if you complete the application yourself. If your agent completes the application on your behalf, do not sign the application until you have verified that all information is complete and accurate.Do not pay with cashPay by check, money orderor bank draft, payable to the company – not the agent.Do not give your agent a blank check or access to your bank account.If you have an automatic teller machine (ATM) card, do not give your card or your access code to anyone.If you do not receive your policy within 45 – 60 days, contact the company or agent.If after contacting the company and/or agent youstill do not receive your policy, or if you suspect fraud, contact the New Hampshire Insurance Department’s Consumer Helpline, tollfree at 1Seek HelpIf you have questions or are unable to resolve a problem with your insurance company or agent, contact: The New Hampshire Insurance Department’s Consumer Division at 8003416, via email at consumerservices@ins.nh.gov or in writing at 21 South Fruit Street; Suite 14; Concord, NH 03301. The New Hampshire Insurance Department distributes this brochure as a courtesy to NH residents. The Depart
ment does not endorse any company, agent or service described herein. Premium rates are based on the information available to the Department at the time of publication and are subject to change. 2 20 2 1 MEDIGAP PLANS How to read the chart: If an "X" appears in a column of this chart, the Medigap policy covers 100% of the described benefit.If a column lists a percentage, the policy covers that percentage of the described benefit.If a column is blank, the policy does not cover that benefit.Note: The Medigap policy covers coinsurance only after the deductible has been paid unless the policy also covers the deductible. MEDIGAP Benefits Plans A B C D F* G * * K L M N Medicare Part A Coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used up.)X X X X X X X X X X Medicare Part B Coinsurance or Copayment X X X X X X 50% 75% X X *** Blood (First 3 Pints) X X X X X X 50% 75% X X Part A. Hospice Care Coinsurance or Co - Payment X X X X X X 50% 75% X X Skilled Nursing Facility Care Coinsurance X X X X 50% 75% X X Medicare Part A Deductible X X X X X 50% 75% 50% X Medicare Part B Deductible X X Medicare Part B excess charges X X Foreign Travel Emergency (Up to Plan Limits) 80% 80% 80% 80% 80% 80% 21 Out of pocket limit: $6,. $3,. Plan F also offers a highdeductible plan. If you choose this option, you must pay for Medicare covered coststo the 2021 deductibleamount before your policy pays anything. Plan G also offers a highdeductible plan. If you choose this option, you must pay for the Medicare covered costs up to the 202deductible amount the Medicare Part B Deductible before your policy pays anything. **Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20.00 for office visits and up to a $50.00 copayment for emergency room visits that do not result in an inpatient admission. 3 2 0 2 1 Medicare Supplement Plans – Rates Effective January 1, 202 1 – December 31, 2021 Company Plans A B C D F F+ G G+ K L M N A ccendo I nsurance Company (CVS Group) X X X X Aetna Health and Life Insurance Company (CVS Group) X X X X X X American Retirement Life Insurance Company (Cigna Health Group) X X X X Americo Financial Life and Annuity Insurance Company (Financial Holdings Grp) X X X X Anthem Health Plans of New Hampshire (Anthem Inc Group) X X X X Cigna Health and Life Ins Company (Cigna Health Group) X X X X X Colonial Penn Life Insurance Company (CNO Financial Group) X X
X X X X X X X X X First Health Life & Health Insurance Company (CVS Group) X X X X X Globe Life and Accident Insurance Company (Globe Life Inc Group) X X X X X X X HPHC Insurance Company (Harvard Pilgrim Health Care Group) X X X X X Humana Insurance Company (Humana Group) X X X X X X X X X X Loyal American Life Insurance Company (Cigna Health Group) X X X X Mutual of Omaha Insurance Company (Mutual of Omaha Group) X X X X X X State Farm Mutual Automobile Insurance Company (State Farm Group) X X X X X X Transamerica Life Insurance Company (AEGON US Holding Group) X X X X X X X X X X United American Insurance Company (Globe Life Inc Group) X X X X X X X X UnitedHealthcare Insurance Company – AARP Members (UnitedHealth Group) X X X X X X X X USAA Life Insurance Company (United Service Automobile Assn Group) X X X X *** Special Note ***his brochure only contains the rate charts which have been approved, as of the date appearing on the cover of this brochure.Whereas this brochure will beupdated periodically, as additional company plans and rates are approved, please visit our website at www.nh.gov/insurance toview the updated brochure. You may also contact the NH Insurance Department’s Consumer Services Division at 13416 (option #2) to obtain updated plan and rateinformation. 4 Accendo Insurance Company (CVS Group) 1021 Reams Fleming Boulevard, Franklin, TN 37064; 1-800-264-4000 (Request Accendo Rates Pre-Existing Condition Limitations: None Age Male Fem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem. 65 353.86307.71472.73411.09445.49387.35320.29278.56 65 167.60145.78223.99194.76211.00183.43148.52129.12 66 169.93147.77226.91197.34213.75185.93151.19131.45 172.68150.11230.57200.50217.16188.84154.27134.20176.01153.11235.07204.42221.49192.59158.19137.53179.59156.19239.82208.58225.99196.50161.94140.78183.43159.52244.99213.00230.74200.67165.60144.03187.67163.18250.73218.00236.32205.42169.77147.61191.76166.77256.15222.74241.49209.92173.43150.86195.67170.18261.48227.41246.32214.16177.01153.86200.09174.01267.31232.49251.82219.00180.93157.27204.42177.76273.06237.49257.31223.74184.84160.69209.08181.84279.39242.90263.14228.83188.92164.35214.58186.59286.55249.23269.98234.74193.92168.60219.58190.92293.22254.98276.31240.32198.50172.60224.91195.59300.46261.31283.14246.15203.42176.93230.82200.75308.54268.23290.55252.65208.92181.68237.16206.25316.79275.47298.38259.48214.58 186.59243.49211.75325.29282.89306.38266.48220.33191.59250.40217.75334.62290.88315.21274.14226.58197.00257.56223.99344.03299.13324.12281.80233.07202.67264.48229.99353.28307.21332.87289.47239.24208.08271.14235.82362.19314.96341.28296.80245.40213.33278.06241.82371.35322.95349.86304.29251.57218.83285.05247.82380
.68331.03358.69311.88257.90224.24292.22254.07390.18339.28367.69319.71264.31229.82299.21260.23399.84347.69376.68327.54270.89235.49306.63266.64409.50356.11385.85335.53277.39241.24 92 313.96272.97419.33364.60395.01343.53284.05246.98 321.20279.30429.08373.10404.25351.53290.55252.65328.29285.47438.49381.35413.17359.36297.05258.31335.28291.55447.65389.34421.83366.77303.30263.73341.53297.05456.15396.67429.91373.85309.04268.73347.19301.88463.65403.17436.91379.85314.04273.06351.53305.63469.48408.17442.24384.60317.96276.47353.86307.71472.73411.09445.49387.35320.29278.56Rates Effective January 1, 2021 Plan N Notes: Forms are generally available to all medicare recipients in the state (for applicants not in an open enrollment period, simple yes/no underwriting applies). A discount factor of .86 is applied for applicants eligible for the Household Discount. Plan M Plan A Plan B Plan C Plan D Plan F Plan F+ Plan G Plan G+ Plan K Plan L 5 Aetna Health and Life Insurance Company (CVS Group) 1021 Reams Fleming Boulevard, Franklin, TN 37067; 1-800-264-4000 (Request Aetna Health Rates Age Male Fem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem. 65 309.88269.48338.70294.55451.07392.18114.6299.63337.45293.38286.89249.48 65 154.77134.61169.02147.02225.16195.7657.1449.73168.43146.44140.78122.37 66 155.94135.61170.52148.19226.91197.3457.7350.15169.68147.61142.36123.78 158.77138.11173.43150.77231.16201.0058.6451.06172.85150.27145.69126.78161.94140.78176.93153.86235.66204.8359.8952.06176.18153.19149.36129.95165.68144.11181.01157.44241.07209.6761.2353.31180.43156.85153.52133.53169.77147.52185.34161.19247.07214.8362.8154.56184.76160.60157.52136.95174.18151.52190.26165.52253.48220.4164.4756.06189.67164.93161.60140.53178.68155.35195.17169.77259.98226.1665.9757.48194.51169.10165.77144.11183.09159.27200.17174.01266.48231.7467.7258.89199.42173.35169.68147.61187.67163.18205.08178.35273.06237.4169.4760.39204.42177.76173.85151.11192.59167.52210.42183.01280.39243.7471.2261.98209.67182.34178.26155.02197.25171.60215.66187.51287.22249.7373.0563.47214.83186.84182.51158.69202.42175.93221.16 192.26294.38255.9874.8965.06220.25191.51187.09162.68207.17180.09226.24196.75301.46262.1576.5566.64225.41196.09191.67166.60212.08184.34231.66201.42308.46268.3178.3968.14230.82200.75196.09170.52216.91188.67236.99206.08315.62274.4780.2269.72236.07205.33200.75174.51221.91193.09242.57210.92323.04280.8982.1371.39241.57210.08205.42178.60227.08197.42248.15215.75330.53287.3983.9773.05247.23215.00210.17182.76232.32202.00253.90220.66338.11293.9785.8874.64252.90219.91215.08187.01237.65206.67259.65225.83345.86300.7187.8876.39258.73224.99219.91191.26243.74211.92266.31231.57354.77308.4690.2178.39265.23230.74225.49196.17248.82216.41271.97236.49362.19314.9692.1380.05270.97235.66230.32200.25254.15220.91277.72241.49370.02321.7093.88 81.72276.56240.57235.16204.50259.48225.58283.47246.48377.60328.3795.8883.47282.39245.57240.15208.75264.73230.24289.30251.65385.35335.1297.8885.13288.22250.65245.15213.08270.23234.91295.05256.65393.18341.9599.8886.88294.05255.65249.9821
7.41275.56239.57301.13261.81400.92348.61101.8888.63299.80260.81254.98221.74280.97244.24306.96266.89408.75355.44103.8890.38305.71265.89259.98226.16286.14248.82312.79271.97416.50362.11105.7991.96311.46270.89264.89230.32291.38253.32318.37276.81424.08368.77107.7993.71317.21275.89269.73234.49296.46257.73323.87281.55431.33375.10109.6295.30322.62280.55274.22238.49301.05261.73329.04285.97437.99380.85111.2996.79327.54284.89278.56242.24304.96265.23333.20289.80443.99386.01112.7998.04331.95288.72282.30 245.49308.21267.98336.62292.72448.32389.84114.0499.13335.37291.63285.14247.98309.88269.48338.70294.55451.07392.18114.6299.63337.45293.38286.89249.48 Pre-Existing Condition Limitations: None Rates Effective January 1, 2021Notes: Forms are generally available to all medicare recipients in the state (for applicants not in an open enrollment period, simple yes/no underwriting applies). A Discount Factor of .93 is applied for applicants eligible for the Household Discount. Plan N Plan M Plan A Plan B Plan C Plan D Plan F Plan F+ Plan G Plan G+ Plan K Plan L 6 American Retirement Life Insurance Company (Cigna Health Group) PO Box 5700, Scranton, PA 18505; 1-866-459-4273 Pre-Existing Condition Limitations: None Age Plan APlan BPlan CPlan DPlan FPlan F+Plan GPlan G+Plan KPlan LPlan MPlan N Male Fem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem. 65 481.57418.76582.62506.62420.56365.70344.92299.94 65 219.47190.84265.52230.88191.66166.66157.19136.69 66 219.47190.84265.52230.88191.66166.66157.19136.69 230.44200.38278.79242.43201.25174.99165.05143.53236.35205.52285.94248.65206.41179.48169.29147.21242.42210.79293.28255.02211.70184.09173.63150.98248.63216.20300.80261.56217.13188.81178.08154.86255.09221.82308.62268.36222.77193.71182.71158.88261.55227.44316.43275.16228.41198.62187.34162.90268.19233.21324.46282.14234.21203.66192.09167.03274.99239.12332.69289.29240.15208.83196.96171.27281.97245.19341.13296.63246.24214.12201.96175.62289.21251.49349.89304.25252.57219.62207.15180.13296.45257.79358.66311.87258.89225.12212.34184.64303.88264.24367.64319.69265.38230.76217.65189.27311.49270.86376.85327.70272.03236.55223.11194.01319.30277.65386.29335.91278.84242.47228.70198.87327.40284.69396.09344.43285.92248.62234.50 203.91335.50291.73405.89352.95292.99254.77240.30208.96343.48298.67415.54361.34299.96260.83246.01213.93351.65305.78425.43369.94307.09267.04251.87219.02360.01313.05435.55378.73314.40273.39257.86224.22368.57320.50445.91387.74321.87279.89263.99229.56377.34328.12456.51396.96329.53286.55270.27235.02386.13335.76467.14406.21337.20293.22276.56240.49394.93343.41477.79415.46344.89299.90282.86245.97403.73351.06488.43424.72352.57306.58289.17251.45412.52358.71499.08433.97360.25313.26295.47256.93421.30366.35509.70443.21367.92319.93301.75262.40430.06373.96520.29452.43375.57326.58308.03267.85438.78381.55530.85461.60383.19333.21314.27273.29447.46389.10541.35470.74390.77339.80320.49278.69456.09396.60551.79479.81398.30346.35 326.67284.07464.66404.05562.16488.83405.79352.86332.81289.40473.16411.44572.43497.76413.21359.31338.90294.70481.57
418.76582.62506.62420.56365.70344.92299.94Rates Effective January 1, 2021Notes: 7% Household discount is available when more than one member of the household enrolls or is enrolled in a Medicare Supplement plan offered by the company. 7 Americo Financial Life and Annuity Insurance Company (Financial Holdings Grp) PO Box 410288, Kansas City, MO 64141-0288; 1-800-231-0801 Pre-Existing Condition Limitations: None Age Male Fem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem. 65 298.85259.87368.95320.82313.61272.70258.26224.58 65 185.21161.05228.65198.83194.36169.01160.06139.18 66 185.21161.05228.65198.83194.36169.01160.06139.18 185.21161.05228.65198.83194.36169.01160.06139.18185.21161.05228.65198.83194.36169.01160.06139.18189.96165.18234.52203.93199.34173.34164.16142.75194.83169.42240.54209.16204.46177.79168.37146.41199.83173.77246.70214.53209.70182.35172.69150.17204.96178.22253.03220.03215.08187.02177.12154.02210.16182.74259.45225.61220.53191.77181.62157.93215.49187.38266.03231.33226.13196.63186.22161.93220.95192.13272.78237.20231.86201.62190.95166.04226.56197.01279.70243.22237.75206.74195.79170.25232.31202.01286.80249.39243.78211.98200.76174.57236.78205.89292.32254.19248.47216.06204.62177.93241.33209.86297.94259.08253.25220.22208.56181.36245.98213.89303.68264.07258.13224.46212.57184.85250.71218.01309.52269.15263.09228.78216.66 188.40255.54222.21315.48274.33268.16233.18220.83192.03259.50225.65320.37278.58272.32236.80224.26195.01263.53229.15325.34282.91276.54240.47227.74198.03267.61232.71330.39287.29280.83244.20231.27201.10271.77236.32335.51291.75285.19247.99234.86204.23275.98239.98340.72296.28289.61251.83238.50207.39278.74242.38344.12299.24292.50254.35240.89209.47281.53244.81347.56302.23295.43256.90243.30211.56284.34247.25351.04305.25298.38259.46245.73213.68287.19249.73354.55308.30301.37262.06248.19215.81290.06252.22358.10311.39304.38264.68250.67217.97292.96254.75361.68314.50307.43267.33253.17220.15295.89257.29365.29317.65310.50270.00255.71222.35298.85259.87368.95320.82313.61272.70258.26224.58298.85259.87368.95320.82313.61272.70 258.26224.58298.85259.87368.95320.82313.61272.70258.26224.58298.85259.87368.95320.82313.61272.70258.26224.58298.85259.87368.95320.82313.61272.70258.26224.58 Plan M Plan N Notes: A 10% Household Premium Discount is available. An applicant is eligible for a Household Premium Discount if for the past year they have resided with at least one, but no more than three, other adults who are age 60 and older. If they live with another adult who is their legal spouse, we will waive both the one-year requirement and the age 60 requirement. Rates Effective January 1, 2021 Plan A Plan B Plan C Plan D Plan F Plan F+ Plan G Plan K Plan L Plan G+ 8 Anthem Health Plans of New Hampshire (Anthem Inc Group) 3000 Goffs Falls Rd, Manchester, NH 03111-0001; 1-800-232-1261 Age Male Fem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem. 65 431.51392.28664.15603.77442.79402.55445.14404.69 65 151.52137.75233.22212.02155.48141.36156.31142.10 66 163.3914
8.52251.47228.60167.65152.41168.54153.21 167.42152.20257.68234.26171.80156.18172.71157.01171.71156.08264.28240.23176.20160.18177.13161.02176.15160.14271.13246.46180.77164.32181.73165.18181.16164.70278.84253.51185.90169.00186.87169.90185.63168.75285.71259.75190.49173.16191.50174.07190.29172.99292.89266.25195.28177.51196.31178.45194.18176.53298.88271.72199.28181.16200.33182.12198.11180.09304.91277.20203.29184.81204.36185.79202.01183.64310.90282.64207.30188.43208.40189.42205.97187.25317.01288.20211.35192.14212.47193.16209.84190.75322.95293.59215.31195.75216.45196.79212.99193.62327.81298.00218.54198.68219.71199.74216.13196.49332.66302.41221.78201.63222.95202.69235.71214.28362.79329.81241.86219.89243.14221.05255.29232.09392.93357.22261.95238.15263.34 239.41274.87249.89423.07384.58282.07256.43283.56257.78294.46267.68453.21411.99302.16274.68303.76276.13314.05285.49483.34439.40322.25292.96323.95294.51333.61303.29513.50466.80342.34311.21344.15312.86353.20321.06543.60494.19362.42329.49364.34331.23372.77338.87573.75521.59382.52347.75384.54349.60392.35356.67603.89548.98402.62366.02404.75367.95411.95374.47634.01576.36422.71384.26424.94386.30431.51392.28664.15603.77442.79402.55445.14404.69431.51392.28664.15603.77442.79402.55445.14404.69431.51392.28664.15603.77442.79402.55445.14404.69431.51392.28664.15603.77442.79402.55445.14404.69431.51392.28664.15603.77442.79402.55445.14404.69431.51392.28664.15603.77442.79402.55445.14404.69431.51392.28664.15603.77442.79402.55 445.14404.69431.51392.28664.15603.77442.79402.55445.14404.69431.51392.28664.15603.77442.79402.55445.14404.69431.51392.28664.15603.77442.79402.55445.14404.69Rates Effective January 1, 2021Notes: Discounts include $48 discount for annual premium payments, $2 discount for electronic funds transfer and Multi-Insured discount of 5% for resdidents from the same occupancy. Pre-Existing Condition Limitations: Maximum Waiting Period: 6 MonthsMaximum Lookback Period: 6 Months Plan G+ Plan N Plan A Plan B Plan C Plan D Plan F Plan F+ Plan G Plan K Plan L Plan M 9 Cigna Health and Life Ins Co (Cigna Health Group) PO Box 5700, Scranton, PA 18505; 1-866-459-4272 Pre-Existing Condition Limitations: None Age Male Fem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem. 65 255.30230.00402.67362.77115.05103.65346.68312.33272.66245.64 65 136.33122.82226.80204.3361.4455.35185.13166.78133.27120.06 66 136.33122.82226.80204.3361.4455.35185.13166.78137.26123.66 136.33122.82226.80204.3361.4455.35185.13166.78141.37127.36136.33122.82226.80204.3361.4455.35185.13166.78145.60131.17140.41126.50232.84209.7663.2857.01190.67171.77149.96135.10144.62130.29239.05215.3665.1758.71196.38176.92154.45139.14148.95134.19245.45221.1367.1260.47202.26182.21159.07143.31153.41138.20252.04227.0769.1362.28208.31187.67163.84147.60158.00142.34258.83233.1871.2064.15214.55193.29168.74152.02162.73146.60265.83239.4873.3366.07220.97199.07173.79156.57167.60150.99273.03245.9775.5368.04227.59205.03179.00161.26172.62155.51280.45252.6577.7970.08234.40211.17184.36166.09177.79160.17288.09259.5480.1272.18241.42217.50
189.87171.06183.11164.96295.95266.6382.5274.34248.65224.01195.56176.18188.59 169.90304.06273.9384.9976.57256.09230.71201.41181.45194.24174.99312.41281.4587.5378.86263.76237.62207.44186.89200.05180.23321.00289.1990.1581.22271.66244.74213.66192.48206.04185.62329.86297.1792.8583.65279.79252.06220.05198.24212.21191.18338.97305.3895.6386.16288.17259.61226.64204.18218.57196.91348.37313.8498.5088.74296.79267.38233.43210.29225.11202.80358.04322.56101.4591.39305.68275.39240.41216.59231.85208.87368.00331.53104.4894.13314.83283.63247.61223.07234.79211.52372.35335.45105.8195.32318.82287.23250.75225.90237.73214.17376.69339.36107.1396.52322.81290.82253.89228.73240.67216.82381.04343.28108.4697.71326.81294.42257.03231.56243.61219.46385.38347.19109.7898.90330.80298.02260.17234.39245.95221.57388.84 350.31110.8499.85333.97300.88262.67236.64248.29223.68392.30353.42111.89100.80337.15303.74265.17238.89250.62225.79395.76356.54112.94101.75340.33306.60267.66241.14252.96227.90399.22359.65114.00102.70343.50309.46270.16243.39255.30230.00402.67362.77115.05103.65346.68312.33272.66245.64255.30230.00402.67362.77115.05103.65346.68312.33272.66245.64255.30230.00402.67362.77115.05103.65346.68312.33272.66245.64255.30230.00402.67362.77115.05103.65346.68312.33272.66245.64255.30230.00402.67362.77115.05103.65346.68312.33272.66245.64Rates Effective January 1, 2021 Notes: Household discount = 0.94 if live with someone and Household discount = 0.85 if multi-policy. The live with someone household discount is applicable when the applicant lives with someone 18 years or older. The multi-policy household discount is applicable if the applicant lives with someone 18 years or older who also has a Medicare Supplement policy with Cigna. The applicant will either be eligible for no household discount, the live with someone household discount (0.94), or the multi-policy discount (0.85), but not a combination of these discounts. An online application discount of 0.95 is applicable when applicants complete and submit an initial application online. Plan G+ Plan N Plan A Plan B Plan C Plan D Plan F Plan F+ Plan G Plan K Plan L Plan M 10 Colonial Penn Life Insurance Company (CNO Financial Group) 111 East Wacker Drive, Suite 2100, Chicago, IL 60601; 1-800-800-2254 Pre-Existing Condition Limitations: None Age Male Fem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem. 65 321.82289.74407.20366.62333.26300.04486.22437.74117.68106.03460.16414.30117.68106.03189.16170.37294.15264.90377.84340.17329.25296.42 65 207.85187.18262.54236.38196.45176.90298.84269.1072.5165.34272.28245.1872.5165.34113.84102.56184.46166.1
2233.95210.68178.66160.89 66 215.49194.05272.01244.93206.35185.80309.60278.7575.0767.68282.99254.8175.0767.68118.06106.37190.75171.79243.43219.22187.15168.56 223.44201.22281.68253.63217.52195.87320.61288.6977.6970.05293.94264.6677.6970.05122.74110.57197.40177.77253.12227.91195.95176.45231.45208.43291.42262.41229.14206.32331.79298.7280.3872.45305.12274.7580.3872.45127.54114.90204.24183.93262.92236.75204.86184.49239.46215.63301.21271.21241.20217.18343.09308.9283.1374.90316.45284.9283.1374.90132.51119.38211.25190.25272.85245.69213.93192.66247.43222.80310.93279.97253.73228.46354.48319.1685.8377.36327.84295.1885.8377.36137.58123.90218.36196.64282.84254.67223.05200.86255.28229.87320.55288.58266.81240.23365.90329.4488.5779.84339.26305.4888.5779.84142.66128.49225.53203.08292.83263.67232.18209.09262.94236.75329.96297.08280.39252.47377.22339.6391.2982.27350.59315.6691.2982.27147.73133.10232.67209.51 302.66272.53241.22217.23270.33243.43339.02305.25294.59265.22388.30349.6193.9684.68361.65325.6393.9684.68152.77137.61239.68215.85312.31281.19250.09225.19277.31249.70347.64313.00309.40278.57399.02359.2396.5386.98372.37335.2696.5386.98157.64141.98246.49221.96321.52289.48258.66232.92283.73255.49355.68320.22324.89292.49409.09368.2898.9689.16382.46344.3498.9689.16162.19146.10252.88227.71330.15297.24266.73240.18289.45260.64362.79326.61341.07307.06418.29376.58101.1391.13391.65352.61101.1391.13166.34149.80258.72232.98337.91304.25274.07246.81294.20264.90368.77332.04358.03322.33426.26383.76103.0792.88399.61359.77103.0792.88169.90153.04263.73237.52344.51310.18280.49252.55297.67268.03373.34336.16375.83338.35432.57389.45104.6094.22405.92365.46104.6094.22 172.71155.55267.65241.03349.50314.66285.51257.10299.60269.74376.03338.57383.34345.09436.66393.13105.5695.13410.00369.14105.5695.13174.40157.07270.06243.18352.38317.27288.78260.03300.64270.70377.53339.90390.98351.97439.05395.26106.1395.63412.40371.27106.1395.63175.11157.69271.22244.23353.63318.37290.66261.74301.73271.66379.03341.27398.78359.00441.37397.41106.7296.15414.77373.43106.7296.15175.83158.36272.38245.26354.86319.50292.58263.47302.83272.64380.57342.63406.74366.16443.78399.52107.2996.67417.16375.60107.2996.67176.52158.99273.53246.32356.08320.63294.51265.19303.90273.61382.10344.00414.84373.45446.17401.66107.8797.20419.57377.76107.8797.20177.25159.64274.72247.38357.33321.73296.43266.94305.00274.60383.59345.35423.12380.91448.58403.85108.4797.73 422.00379.95108.4797.73177.99160.30275.90248.44358.58322.84298.43268.67306.08275.57385.13346.74431.56388.51451.01406.04109.0698.28424.44382.14109.0698.28178.70160.93277.06249.52359.84323.98300.37270.44307.18276.56386.67348.13440.19396.26453.43408.21109.6798.79426.92384.34109.6798.79179.45161.59278.26250.58361.08325.12302.33272.23308.28277.55388.18349.52448.95404.16455.85410.40110.2799.32429.38386.57110.2799.32180.17162.26279.42251.64362.34326.23304.32274.04309.37278.56389.75350.92457.91412.22458.32412.63110.8699.87431.87388.82110.8699.87180.88162.93280.63252.74363.61327.38306.34275.83310.50279.56391.31352.32467.07420.45460.79414.84111.47100.42434.37391.08111.47100.421
81.63163.59281.84253.81364.89328.51308.35277.63311.62280.55392.88353.71476.38428.85 463.28417.09112.09100.97436.89393.31112.09100.97182.36164.25283.05254.89366.16329.66310.37279.46312.72281.58394.45355.14485.89437.40465.76419.32112.69101.52439.41395.61112.69101.52183.12164.91284.26255.97367.44330.81312.41281.31313.86282.56396.01356.54495.58446.13468.28421.60113.29102.06441.94397.90113.29102.06183.85165.59285.49257.10368.72331.97314.46283.13314.98283.58397.58357.98505.49455.04470.81423.88113.90102.60444.49400.19113.90102.60184.61166.29286.72258.19370.00333.13316.52284.99316.10284.60399.19359.39515.57464.11473.32426.15114.53103.18447.05402.53114.53103.18185.37166.96287.93259.28371.30334.30318.62286.89317.25285.63400.78360.83525.85473.38475.89428.44115.16103.75449.64404.84115.16103.75186.11167.62289.16260.42372.60335.45320.72288.76318.36286.64 402.40362.27536.36482.82478.44430.77115.78104.31452.25407.17115.78104.31186.87168.30290.41261.52373.88336.62322.84290.65319.51287.69403.98363.72547.06492.46481.03433.09116.42104.88454.86409.54116.42104.88187.66169.00291.65262.62375.21337.81324.96292.56320.65288.71405.60365.17557.99502.29483.63435.42117.04105.43457.52411.92117.04105.43188.42169.67292.89263.78376.53338.98327.10294.49321.82289.74407.20366.62569.13512.31486.22437.74117.68106.03460.16414.30117.68106.03189.16170.37294.15264.90377.84340.17329.25296.42Rates Effective January 1, 2021 Plan N Notes: No restrictions Plan M Plan A Plan B Plan C Plan D Plan F Plan F+ Plan G Plan G+ Plan K Plan L 11 First Health Life & Health Insurance Company (CVS Group) 3200 Highland Avenue, Downers Grove, IL 60515; 1-800-264-4000 Request First Health Life Rates Pre-Existing Condition Limitations: None Age Male Fem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem. 65 187.67173.01248.32230.32306.54285.80289.38271.14177.35167.10 65 146.02134.53171.01158.69201.25187.59185.01173.43109.87103.46 66 149.19137.45175.43162.68206.75192.76190.17178.26112.95106.46 152.27140.28179.84166.85212.17197.84195.34183.09116.20109.37155.19142.94184.09170.68217.41202.75200.34187.67119.20112.37158.02145.53188.26174.51222.66207.67205.33192.42122.37115.20160.77148.02192.34178.35227.83212.50210.33197.09125.53118.12163.27150.44196.42182.26233.07217.41215.33201.75128.62121.12165.77152.77200.59185.93238.24222.33220.33206.42131.70124.12168.02154.85204.25189.51243.15226.83225.16211.00134.70126.87170.18156.69208.00192.84248.07231.41229.91215.33137.69129.70172.01158.60211.50196.17252.82235.74234.49219.75140.61132.53173.85160.10215.00199.42257.40240.07238.99223.91143.53135.36175.26161.52218.16202.42261.90244.24243.40228.08146.44137.94176.43162.52221.08205.00265.81247.90247.40231.82149.11140.44177.35 163.35223.91207.67269.81251.65251.32235.49151.77142.94178.43164.43226.58210.17273.64255.15255.23239.24154.35145.36179.59165.43229.41212.75277.72258.98259.48243.07157.02147.94180.68166.52232.07215.25281.64262.73263.48246.90159.85150.44181.84167.60234.66217.66285.55266.39267.56250.73162.52153.11183.01168.52237.24220.00289.47269.98271.56254.40165.35155.69183.931
69.52239.65222.33293.22273.47275.39258.06167.93158.19184.93170.52241.99224.41296.80276.72279.14261.48170.52160.60186.01171.35244.24226.49300.13279.89282.55264.81172.85162.85186.76172.01245.98228.24303.05282.55285.55267.56174.93164.60187.34172.68247.48229.49305.29284.72287.97269.81176.51166.27187.67173.01248.32230.32306.54285.80289.38271.14177.35167.10187.67173.01248.32 230.32306.54285.80289.38271.14177.35167.10187.67173.01248.32230.32306.54285.80289.38271.14177.35167.10187.67173.01248.32230.32306.54285.80289.38271.14177.35167.10187.67173.01248.32230.32306.54285.80289.38271.14177.35167.10187.67173.01248.32230.32306.54285.80289.38271.14177.35167.10187.67173.01248.32230.32306.54285.80289.38271.14177.35167.10187.67173.01248.32230.32306.54285.80289.38271.14177.35167.10187.67173.01248.32230.32306.54285.80289.38271.14177.35167.10187.67173.01248.32230.32306.54285.80289.38271.14177.35167.10Notes No restrictions Plan N Rates Effective January 1, 2021 Plan M Plan A Plan B Plan C Plan D Plan F Plan F+ Plan G Plan G+ Plan K Plan L 12 Globe Life and Accident Insurance Company (Globe Life Inc Group) PO Box 8080 McKinney, TX 75070; 1-800-801-6831 Pre-Existing Condition Limitations: Yes, policy contains a 6 month pre-existing condition limit. See note below. Age Male Fem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem. 65 169.50169.50262.00262.00375.50375.5092.5092.50352.50352.5092.5092.50277.50277.50 65 120.50120.50174.50174.50219.00219.0057.5057.50199.50199.5057.5057.50154.50154.50 66 126.00126.00184.50184.50233.50233.5061.0061.00214.50214.5061.0061.00165.50165.50 126.00126.00184.50184.50233.50233.5061.0061.00214.50214.5061.0061.00165.50165.50126.00126.00184.50184.50233.50233.5061.0061.00214.50214.5061.0061.00165.50165.50126.00126.00184.50184.50233.50233.5061.0061.00214.50214.5061.0061.00165.50165.50134.00134.00202.00202.00265.00265.0066.5066.50245.50245.5066.5066.50191.00191.00134.00134.00202.00202.00265.00265.0066.5066.50245.50245.5066.5066.50191.00191.00134.00134.00202.00202.00265.00265.0066.5066.50245.50245.5066.5066.50191.00191.00134.00134.00202.00202.00265.00265.0066.5066.50245.50245.5066.5066.50191.00191.00134.00134.00202.00202.00265.00265.0066.5066.50245.50245.5066.5066.50191.00191.00138.00138.00213.50213.50290.50290.5071.5071.50271.00271.0071.5071.50212.00 212.00138.00138.00213.50213.50290.50290.5071.5071.50271.00271.0071.5071.50212.00212.00138.00138.00213.50213.50290.50290.5071.5071.50271.00271.0071.5071.50212.00212.00138.00138.00213.50213.50290.50290.5071.5071.50271.00271.0071.5071.50212.00212.00138.00138.00213.50213.50290.50290.5071.5071.50271.00271.0071.5071.50212.00212.00141.50141.50218.50218.50313.00313.0077.0077.00294.00294.0077.0077.00231.00231.00141.50141.50218.50218.50313.00313.0077.0077.00294.00294.0077.0077.00231.00231.00141.50141.50218.50218.50313.00313.0077.0077.00294.00294.0077.0077.00231.00231.00141.50141.50218.50218.50313.00313.0077.0077.00294.00294.0077.0077.00231.00231.00141.50141.50218.50218.50313.00313.0077.0077.00294.00294.0077.0077.00 231.00231.00155.50155.50240.50240.50344.
50344.5085.0085.00323.50323.5085.0085.00254.50254.50155.50155.50240.50240.50344.50344.5085.0085.00323.50323.5085.0085.00254.50254.50155.50155.50240.50240.50344.50344.5085.0085.00323.50323.5085.0085.00254.50254.50155.50155.50240.50240.50344.50344.5085.0085.00323.50323.5085.0085.00254.50254.50155.50155.50240.50240.50344.50344.5085.0085.00323.50323.5085.0085.00254.50254.50169.50169.50262.00262.00375.50375.5092.5092.50352.50352.5092.5092.50277.50277.50169.50169.50262.00262.00375.50375.5092.5092.50352.50352.5092.5092.50277.50277.50169.50169.50262.00262.00375.50375.5092.5092.50352.50352.5092.5092.50277.50277.50169.50169.50262.00262.00375.50375.5092.5092.50352.50352.5092.50 92.50277.50277.50169.50169.50262.00262.00375.50375.5092.5092.50352.50352.5092.5092.50277.50277.50169.50169.50262.00262.00375.50375.5092.5092.50352.50352.5092.5092.50277.50277.50169.50169.50262.00262.00375.50375.5092.5092.50352.50352.5092.5092.50277.50277.50169.50169.50262.00262.00375.50375.5092.5092.50352.50352.5092.5092.50277.50277.50169.50169.50262.00262.00375.50375.5092.5092.50352.50352.5092.5092.50277.50277.50169.50169.50262.00262.00375.50375.5092.5092.50352.50352.5092.5092.50277.50277.50 Plan L Plan M Plan N Rates Effective January 1, 2021 Notes: Pre-existing Condition Limitation: Pre-Existing Condition means an injury sustained or Sickness first manifesting itself prior to the policy effective date for which medical advice or treatment was recommended or given by a Physician within 6 months prior to the policy effective date. Loss due to a Pre-Existing Condition is not covered unless the loss is incurred more than 60 days after the policy effective date. Pre-existing conditions limitations do not apply to applicants eligible for guaranteed issue pursuant to INS 1905.13, and pre-existing limitations are waived to the extent of prior creditable coverage for applicants eligible for open enrollment or when replacing a Medicare supplement policy. No other restrictions. Plan A Plan B Plan C Plan D Plan F Plan F+ Plan G Plan G+ Plan K 13 HPHC Insurance Company Pre-Existing Condition Limitations: None Male Fem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem. 65 335.00335.00502.00502.00368.00368.00365.00365.00355.00355.00 65 184.00184.00227.00227.00155.00155.00188.00188.00160.00160.00 66 187.00187.00230.00230.00172.00172.00190.00190.00163.00163.00 191.00191.00239.00239.00181.00181.00193.00193.00167.00167.00198.00198.00246.00246.00189.00189.00203.00203.00177.00177.00202.00202.00254.00254.00198.00198.00209.00209.00181.00181.00207.00207.00266.00266.00206.00206.00216.00216.00185.00185.00216.00216.00271.00271.00214.00214.00221.00221.00192.00192.00222.00222.00277.00277.00222.00222.00226.00226.00201.00201.00225.00225.00284.00284.00232.00232.00230.00230.00205.00205.00227.00227.00290.00290.00241.00241.00237.00237.00208.00208.00234.00234.00296.00296.00250.00250.00241.00241.00214.00214.00237.00237.00302.00302.00260.00260.00245.00245.00217.00217.00244.00244.00310.00310.00271.00271.00247.00247.00223.00223.00246.00246.00315.00315.00281.00281
.00253.00253.00229.00229.00252.00 252.00320.00320.00292.00292.00256.00256.00232.00232.00335.00335.00502.00502.00368.00368.00365.00365.00355.00355.00335.00335.00502.00502.00368.00368.00365.00365.00355.00355.00335.00335.00502.00502.00368.00368.00365.00365.00355.00355.00335.00335.00502.00502.00368.00368.00365.00365.00355.00355.00335.00335.00502.00502.00368.00368.00365.00365.00355.00355.00335.00335.00502.00502.00368.00368.00365.00365.00355.00355.00335.00335.00502.00502.00368.00368.00365.00365.00355.00355.00335.00335.00502.00502.00368.00368.00365.00365.00355.00355.00335.00335.00502.00502.00368.00368.00365.00365.00355.00355.00335.00335.00502.00502.00368.00368.00365.00365.00355.00355.00335.00335.00502.00502.00368.00368.00365.00365.00355.00355.00335.00335.00502.00 502.00368.00368.00365.00365.00355.00355.00335.00335.00502.00502.00368.00368.00365.00365.00355.00355.00335.00335.00502.00502.00368.00368.00365.00365.00355.00355.00335.00335.00502.00502.00368.00368.00365.00365.00355.00355.00335.00335.00502.00502.00368.00368.00365.00365.00355.00355.00335.00335.00502.00502.00368.00368.00365.00365.00355.00355.00335.00335.00502.00502.00368.00368.00365.00365.00355.00355.00335.00335.00502.00502.00368.00368.00365.00365.00355.00355.00335.00335.00502.00502.00368.00368.00365.00365.00355.00355.00 93 Worcester Street, Wellesley, MA 02481; 1-877-907-4742 Plan G+ Notes: No restrictions Plan N (Harvard Pilgrim Health Care Group) Age Plan A Plan B Plan C Plan D Plan F Plan F+ Plan G Plan K Plan L Plan M Rates Effective January 1, 2021 14 Humana Insurance Company (Humana Group) 500 West Main Street, Louisville, KY 40202; 1-888-310-8482 & 1-877-833-4486 TTY/TDD Pre-Existing Condition Limitations: 3 Mos. (N/A for policies issued under guaranteed issue status) Age Male Fem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem. 65 313.86266.70341.42290.08448.51380.98457.62388.7198.2783.71419.81356.6193.1179.33225.29191.52293.50249.41338.69287.77 65 208.01200.08226.21217.58296.95285.60302.97291.3965.5963.15277.99267.3762.1859.87149.50143.83194.55187.15224.41215.85 66 211.22201.99229.71219.66301.55288.33307.67294.1866.5963.74282.30269.9263.1260.42151.80145.19197.56188.93227.88217.91 217.53206.64236.57224.72310.58294.99316.88300.9768.5365.17290.74276.1664.9661.78156.32148.52203.45193.28234.69222.93223.66211.26243.24229.75319.36301.61325.84307.7270.4366.60298.96282.3566.7663.13160.71151.83209.19197.60241.31227.92230.00215.72250.14234.60328.44307.99335.10314.2472.3867.97307.45288.3268.6164.44165.25155.02215.11201.76248.15232.73236.48220.09257.20239.36337.72314.26344.57320.6374.3969.33316.14294.1870.5065.71169.89158.15221.17205.85255.15237.46242.90224.44264.18244.10346.91320.48353.95326.9876.3770.67324.73300.0172.3866.99174.48161.27227.17209.92262.08242.15249.45228.84271.31248.88356.29326.78363.52333.4178.3972.03333.51305.9074.2968.27179.17164.42233.29214.03269.15246.90255.94233.23278.37253.66365.58333.06373.00 339.8280.3973.38342.20311.7876.1969.55183.82167.56239.36218.13276.16251.64262.45237.44285.46258.24374.90339.09382.51345.9782.4074.68
350.92317.4278.0970.78188.48170.57245.44222.06283.18256.18268.71241.45292.28262.61383.87344.84391.66351.8384.3375.92359.32322.8079.9271.95192.97173.45251.30225.82289.95260.52274.91245.40299.02266.90392.74350.49400.71357.6086.2577.14367.62328.0881.7373.11197.40176.27257.09229.51296.64264.78280.79249.06305.42270.89401.15355.73409.30362.9588.0678.27375.49332.9983.4574.18201.61178.90262.58232.93302.98268.73286.34252.42311.46274.55409.10360.55417.41367.8689.7879.31382.93337.4985.0775.16205.59181.30267.77236.07308.98272.36291.61255.36317.20277.74416.65364.74425.11372.1591.4080.21389.99341.4286.6176.02209.36 183.40272.70238.81314.67275.53296.77258.12322.81280.75424.04368.71432.65376.1993.0081.07396.90345.1388.1176.82213.05185.38277.52241.40320.24278.51301.59260.67328.06283.52430.94372.34439.70379.9094.4881.85403.36348.5389.5277.57216.51187.20282.03243.77325.44281.26305.95262.89332.81285.94437.19375.53446.07383.1695.8382.54409.21351.5290.8078.22219.63188.80286.10245.86330.15283.66309.65264.77336.83287.98442.48378.22451.47385.9096.9783.12414.16354.0391.8878.77222.28190.14289.56247.61334.15285.69312.41266.09339.83289.42446.43380.11455.50387.8297.8283.52417.85355.8092.6879.15224.25191.09292.14248.84337.12287.11313.86266.70341.42290.08448.51380.98457.62388.7198.2783.71419.81356.6193.1179.33225.29191.52293.50249.41338.69287.77313.86266.70 341.42290.08448.51380.98457.62388.7198.2783.71419.81356.6193.1179.33225.29191.52293.50249.41338.69287.77313.86266.70341.42290.08448.51380.98457.62388.7198.2783.71419.81356.6193.1179.33225.29191.52293.50249.41338.69287.77313.86266.70341.42290.08448.51380.98457.62388.7198.2783.71419.81356.6193.1179.33225.29191.52293.50249.41338.69287.77313.86266.70341.42290.08448.51380.98457.62388.7198.2783.71419.81356.6193.1179.33225.29191.52293.50249.41338.69287.77313.86266.70341.42290.08448.51380.98457.62388.7198.2783.71419.81356.6193.1179.33225.29191.52293.50249.41338.69287.77313.86266.70341.42290.08448.51380.98457.62388.7198.2783.71419.81356.6193.1179.33225.29191.52293.50249.41338.69287.77313.86266.70341.42290.08448.51380.98457.62388.7198.2783.71 419.81356.6193.1179.33225.29191.52293.50249.41338.69287.77313.86266.70341.42290.08448.51380.98457.62388.7198.2783.71419.81356.6193.1179.33225.29191.52293.50249.41338.69287.77313.86266.70341.42290.08448.51380.98457.62388.7198.2783.71419.81356.6193.1179.33225.29191.52293.50249.41338.69287.77313.86266.70341.42290.08448.51380.98457.62388.7198.2783.71419.81356.6193.1179.33225.29191.52293.50249.41338.69287.77313.86266.70341.42290.08448.51380.98457.62388.7198.2783.71419.81356.6193.1179.33225.29191.52293.50249.41338.69287.77313.86266.70341.42290.08448.51380.98457.62388.7198.2783.71419.81356.6193.1179.33225.29191.52293.50249.41338.69287.77313.86266.70341.42290.08448.51380.98457.62388.7198.2783.71419.81356.6193.1179.33225.29191.52293.50249.41 338.69287.77313.86266.70341.42290.08448.51380.98457.62388.7198.2783.71419.81356.6193.1179.33225.29191.52293.50249.41338.69287.77 Plan N Rates Effective January 1, 2021Notes: A discount is available for automatic bank withdrawal, for those policyholders
that complete and submit an application online - 6.0%, and for those policyholders living at the same address - 5.0%. Polices not issued under guaranteed issue status are subject to medical underwriting. Plan M Plan A Plan B Plan C Plan D Plan F Plan F+ Plan G Plan G+ Plan K Plan L 15 Loyal American Life Insurance Company Pre-Existing Condition Limitations: Yes, policy contains a 6 month pre-existing condition limit. Male Fem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem. 65 379.83316.59669.38558.07571.61476.17535.99446.48 65 320.69296.93422.85391.44355.33329.04318.43294.81 66 320.69296.93422.85391.44355.33329.04318.43294.81 320.69296.93422.85391.44355.33329.04318.43294.81323.83299.93431.87399.91363.41336.48325.58301.44328.89301.71443.48406.87373.68342.89334.77307.06333.94303.62455.50414.11384.32349.30344.09312.81338.99305.39467.65421.35395.10355.97353.66318.55344.18307.31480.22428.73406.13362.64363.50324.55349.37309.22493.06436.37417.55369.44373.58330.55354.70311.13506.17444.02429.09376.37383.92336.68358.80312.09518.87451.13440.38382.91395.41343.83363.03312.91531.84458.50451.80389.45407.29351.11367.27313.86545.09465.88463.60396.25419.55358.52371.50314.82558.61473.39475.66403.05432.06366.18375.60315.64569.68478.71485.28407.80441.63371.16379.83316.59581.01484.18495.28412.67451.46376.26379.83316.59586.75488.96500.42416.91459.38 382.77379.83316.59592.62493.88505.55421.27466.27388.52379.83316.59598.50498.79510.81425.63473.30394.39379.83316.59604.51503.85516.07429.99480.32400.27379.83316.59609.01507.53519.91433.33487.60406.27379.83316.59615.16512.59525.17437.69492.45410.35379.83316.59621.30517.78530.43442.05497.43414.44379.83316.59627.45522.97535.69446.41502.41418.52379.83316.59633.73528.16541.08450.90507.39422.74379.83316.59640.02533.48546.47455.39512.49426.95379.83316.59643.16536.22549.16457.70515.05429.12379.83316.59646.44538.95551.86460.01517.60431.29379.83316.59649.71541.68554.68462.32520.15433.46379.83316.59652.99544.41557.50464.63522.71435.63379.83316.59656.27547.14560.32466.93525.26437.80379.83316.59659.55549.87563.14469.24 527.94439.97379.83316.59662.83552.60565.97471.55530.62442.14379.83316.59666.10555.34568.79473.86533.31444.31379.83316.59669.38558.07571.61476.17535.99446.48 Plan G+ Notes: No restrictions Plan N (Cigna Health Group) Age Plan A Plan B Plan C Plan D Plan F Plan F+ Plan G Plan K Plan L Plan M Rates Effective January 1, 2021 PO Box 559004 Austin, TX 78755-9004; 1-800-633-6752 16 Mutual of Omaha Insurance Company Pre-Existing Condition Limitations: None Male Fem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem. 65 305.67265.25438.37380.43117.39101.87365.03316.78148.91129.48275.29238.90 65 203.77176.84292.25253.6278.2667.92243.36211.1963.6755.36183.53159.28 66 203.77176.84292.25253.6278.2667.92243.36211.1963.6755.36183.53159.28 203.77176.84292.25253.6278.2667.92243.36211.1963.6755.36183.53159.28208.46180.91298.96259.4680.0669.48248.95216.0465.4556.92187.75162.94212.83184.70305.26264.9181.7570.94254.18220.5867.2358.46191.69166.36216.8
7188.22311.04269.9483.3072.29259.00224.7869.0260.02195.34169.52220.78191.60316.64274.8084.8073.59263.67228.8270.8061.56198.85172.57224.54194.86322.03279.4786.2374.85268.16232.7172.5863.11202.23175.51228.24198.08327.34284.0787.6776.08272.57236.5574.4864.76205.58178.41231.90201.24332.58288.6289.0777.29276.94240.3376.3666.40208.86181.25235.48204.36337.74293.1090.4478.49281.22244.0678.2468.04212.11184.07239.01207.43342.80297.4991.8079.67285.45247.7280.1469.68215.28186.83242.57210.52347.92 301.9393.1680.85289.71251.4182.0371.32218.49189.61246.17213.64353.06306.4094.5482.05293.99255.1485.3074.17221.72192.42249.77216.76358.22310.8795.9383.25298.28258.8688.5877.02224.96195.23253.28219.82363.27315.2697.2884.42302.49262.5291.8779.89228.13197.98256.71222.78368.17319.5198.6085.56306.57266.0595.1582.74231.22200.65260.06225.69372.99323.6999.8886.67310.59269.5498.4385.59234.21203.26263.14228.37377.41327.53101.0687.70314.26272.73104.5490.90237.01205.68265.95230.80381.42331.00102.1488.63317.61275.63110.6396.21239.51207.86268.61233.11385.23334.32103.1589.52320.77278.40116.74101.51241.92209.94271.29235.44389.08337.67104.1990.42323.99281.17122.84106.82244.33212.04274.00237.79392.99341.04105.2391.32327.22 283.98128.94112.12246.78214.16276.75240.17396.89344.44106.2892.24330.50286.82130.62113.59249.24216.30279.51242.57400.87347.90107.3493.16333.80289.70132.32115.06251.74218.46282.03244.75404.49351.02108.3194.00336.81292.30134.04116.55254.00220.44284.56246.95408.12354.19109.2994.85339.84294.94135.78118.07256.29222.42287.12249.16411.80357.37110.2695.70342.90297.57137.54119.61258.59224.41289.71251.42415.50360.59111.2696.56345.99300.27139.34121.16260.92226.44292.31253.68419.23363.83112.2697.42349.09302.96141.15122.73263.26228.48294.95255.96423.02367.11113.2798.30352.25305.69142.97124.33265.64230.53297.60258.27426.83370.42114.2999.18355.41308.45144.84125.95268.03232.61300.28260.59430.67373.74115.31100.08358.61311.22146.72127.58270.44 234.70302.98262.94434.54377.11116.36100.98361.83314.02148.63129.25272.88236.82305.67265.25438.37380.43117.39101.87365.03316.78150.56130.92275.29238.90Notes: Rates are 12% lower if you are eligible for the household discount premium. Plan N (Mutual of Omaha Group) Age Plan A Plan B Plan C Plan D Plan F Plan F+ Plan G Plan K Plan L Plan M Rates Effective January 1, 2021 3300 Mutual of Omaha Plaza, Omaha, NE 68175; 1-800-667-2937 Plan G+ 17 State Farm Mutual Auto. Insurance Company (State Farm Group) 1 State Farm Plaza, Bloomington, IL 61710-0001; 1-866-855-1212 Pre-Existing Condition Limitations: None Age Male Fem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem. 65 202.72187.00305.74282.20283.98241.40308.63284.92284.32241.48233.24200.68 65 147.47136.25222.61205.44162.60147.30224.82207.48162.94147.64126.05113.05 66 153.00141.10230.69213.01168.47151.55232.98215.13168.72151.81130.47116.28 157.93145.86238.17219.81173.82155.72240.55222.02174.08155.97134.72119.68162.35149.85245.14226.18179.18159.80247.60228.48179.43160.14138.89122.82166.68153.76251.34232.13184.19163.71253.98234.34184.70164.13142.9
7126.22170.85157.76257.55237.74189.38167.70260.35240.12189.63167.96147.05129.54174.93161.41263.67243.35194.31171.53266.30245.82194.73171.78150.96132.77178.75164.81269.62248.71199.15175.35272.34251.17199.49175.61154.95135.83182.41168.30275.06253.89203.91178.84277.86256.44204.25179.35158.86139.06185.89171.53280.33258.74208.50182.49283.13261.29208.84182.83162.69142.20189.04174.33285.09263.07213.01186.06287.89265.71213.52186.32166.51145.26191.93177.14289.68267.32217.51189.46292.48269.96217.94189.80170.25148.41194.56179.52293.50 270.89221.76192.86296.48273.53222.36193.12174.08151.47196.69181.56296.82273.78226.10196.09299.79276.59226.61196.43177.90154.44198.56183.26299.45276.25230.43199.32302.43279.14230.86199.58181.56157.50199.92184.36301.58278.20234.51202.38304.55281.01235.11202.72185.30160.39200.94185.38303.02279.73238.68205.44306.08282.54239.10205.78188.95163.37201.62186.06304.21280.75242.67208.50307.19283.47243.10208.76192.61166.43202.04186.40304.81281.26246.58211.48307.95284.24247.01211.65196.26169.23202.55186.91305.49281.94250.49214.28308.46284.66250.83214.54199.92172.04202.72187.00305.74282.20254.15217.00308.63284.92254.57217.26203.32174.93202.72187.00305.74282.20257.63219.72308.63284.92258.06220.06206.80177.82202.72187.00305.74282.20261.12222.44308.63 284.92261.46222.70210.12180.62202.72187.00305.74282.20264.35225.16308.63284.92264.86225.33213.52183.43202.72187.00305.74282.20267.58227.63308.63284.92268.00227.88216.66186.23202.72187.00305.74282.20270.55230.09308.63284.92270.98230.35219.72188.87202.72187.00305.74282.20273.53232.73308.63284.92273.87232.81222.70191.59202.72187.00305.74282.20276.33234.94308.63284.92276.59235.19225.59194.14202.72187.00305.74282.20278.97237.23308.63284.92279.31237.49228.39196.52202.72187.00305.74282.20281.52239.36308.63284.92281.94239.53230.94198.64202.72187.00305.74282.20283.98241.40308.63284.92284.32241.48233.24200.68202.72187.00305.74282.20283.98241.40308.63284.92284.32241.48233.24200.68202.72187.00305.74282.20283.98241.40308.63284.92284.32241.48233.24 200.68202.72187.00305.74282.20283.98241.40308.63284.92284.32241.48233.24200.68202.72187.00305.74282.20283.98241.40308.63284.92284.32241.48233.24200.68 Plan N Rates Effective January 1, 2021 Notes: Availability restrictions: 1) Applicants covered by Medicaid are not eligible except in the following situations: a. Persons covered for medical assistance through the state Medicaid program as a Specified Low-Income Medicare Beneficiary (SLMB), OR b. Persons receiving premium paying assistance only from the state Medicaid program. In either of these exception situations, written documentation from the government office administering the program is required and should be submitted with the application. 2) Applicants not enrolled in both Part A and B of Medicare are not eligible. Plan M Plan A Plan B Plan C Plan D Plan F Plan F+ Plan G Plan G+ Plan K Plan L 18 Transamerica Life Insurance Company (AEGON US Holding Group) 2700 West Plano Parkway, Plano, TX 75075; 1-800-797-2643 Pre-Existing Condition Limitations: Yes, 6 months Age Male Fem.MaleFem.MaleFem.Ma
leFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem. 65 329.24288.61434.70381.06514.31450.85452.81396.94517.30453.47452.59396.75202.19177.24300.13263.10369.56323.96347.52304.64 65 155.60141.91205.44187.37243.07221.68214.00195.17244.48222.97213.90195.0895.5687.15141.84129.36174.66159.29164.24149.79 66 163.51148.70215.88196.33255.42232.29224.87204.51256.90233.64224.77204.41100.4191.32149.05135.55183.53166.91172.58156.95 171.83155.81226.87205.72268.42243.39236.32214.29269.98244.81236.21214.19105.5295.68156.64142.03192.87174.89181.37164.46180.65163.25238.52215.55282.20255.03248.45224.53283.84256.51248.33224.42110.94100.26164.68148.82202.78183.25190.68172.32189.66170.78250.42225.48296.28266.78260.85234.88298.00268.33260.72234.76116.47104.88172.89155.68212.89191.70200.19180.26198.99178.40262.73235.54310.84278.68273.67245.36312.65280.30273.54245.24122.20109.56181.39162.63223.36200.25210.03188.30208.62186.12275.45245.74325.90290.75286.93255.98327.79292.44286.79255.86128.12114.30190.18169.67234.18208.92220.21196.46218.46193.93288.43256.05341.26302.94300.45266.72343.24304.70300.31266.59134.16119.09199.14176.78245.22217.68230.59204.70228.33201.73301.46266.36356.68315.14314.02 277.45358.75316.97313.87277.32140.22123.89208.14183.90256.29226.44241.00212.94238.12209.50314.40276.60371.98327.26327.49288.13374.14329.16327.34287.99146.23128.65217.07190.97267.29235.16251.34221.13247.74217.18327.10286.75387.01339.26340.73298.69389.26341.23340.56298.55152.14133.37225.84197.98278.09243.78261.50229.24257.19224.80339.58296.81401.77351.18353.72309.18404.10353.22353.55309.03157.94138.05234.45204.93288.70252.34271.47237.29266.46232.45351.81306.91416.25363.12366.47319.70418.66365.23366.29319.55163.63142.75242.90211.90299.10260.92281.26245.36275.59240.18363.87317.11430.52375.19379.03330.32433.02377.37378.85330.16169.24147.49251.23218.94309.35269.59290.90253.51284.65248.03375.83327.48444.66387.46391.49341.13447.24389.71391.30340.96174.80152.32259.48 226.10319.51278.41300.45261.80293.65256.03387.71338.05458.72399.96403.86352.13461.38402.28403.67351.96180.33157.23267.69233.40329.62287.39309.95270.25302.60264.14399.54348.76472.71412.63416.18363.28475.46415.03415.98363.11185.83162.21275.85240.79339.67296.50319.41278.81311.52272.31411.31359.54486.64425.39428.45374.52489.47427.86428.24374.34191.31167.23283.98248.24349.68305.67328.82287.43320.40280.48423.03370.33500.50438.15440.65385.76503.41440.70440.44385.57196.76172.25292.07255.69359.64314.84338.19296.06329.24288.61434.70381.06514.31450.85452.81396.94517.30453.47452.59396.75202.19177.24300.13263.10369.56323.96347.52304.64329.24288.61434.70381.06514.31450.85452.81396.94517.30453.47452.59396.75202.19177.24300.13263.10369.56323.96347.52304.64329.24288.61 434.70381.06514.31450.85452.81396.94517.30453.47452.59396.75202.19177.24300.13263.10369.56323.96347.52304.64329.24288.61434.70381.06514.31450.85452.81396.94517.30453.47452.59396.75202.19177.24300.13263.10369.56323.96347.52304.64329.24288.61434.70381.06514.31450.85452.81396.94517.30453.47452.59396.75202.19177.24300.13263.10369.56323.96347.52304.64329.2
4288.61434.70381.06514.31450.85452.81396.94517.30453.47452.59396.75202.19177.24300.13263.10369.56323.96347.52304.64329.24288.61434.70381.06514.31450.85452.81396.94517.30453.47452.59396.75202.19177.24300.13263.10369.56323.96347.52304.64329.24288.61434.70381.06514.31450.85452.81396.94517.30453.47452.59396.75202.19177.24300.13263.10369.56323.96347.52304.64329.24288.61434.70381.06514.31450.85452.81396.94517.30453.47 452.59396.75202.19177.24300.13263.10369.56323.96347.52304.64329.24288.61434.70381.06514.31450.85452.81396.94517.30453.47452.59396.75202.19177.24300.13263.10369.56323.96347.52304.64329.24288.61434.70381.06514.31450.85452.81396.94517.30453.47452.59396.75202.19177.24300.13263.10369.56323.96347.52304.64329.24288.61434.70381.06514.31450.85452.81396.94517.30453.47452.59396.75202.19177.24300.13263.10369.56323.96347.52304.64329.24288.61434.70381.06514.31450.85452.81396.94517.30453.47452.59396.75202.19177.24300.13263.10369.56323.96347.52304.64329.24288.61434.70381.06514.31450.85452.81396.94517.30453.47452.59396.75202.19177.24300.13263.10369.56323.96347.52304.64329.24288.61434.70381.06514.31450.85452.81396.94517.30453.47452.59396.75202.19177.24300.13263.10369.56323.96 347.52304.64329.24288.61434.70381.06514.31450.85452.81396.94517.30453.47452.59396.75202.19177.24300.13263.10369.56323.96347.52304.64Rates Effective January 1, 2021 Plan N Notes:There are no marketing, membership restrictions or fees charged. We do offer a 2.0% discount on premiums for ACH/EFT modal premium billing. Plan M Plan A Plan B Plan C Plan D Plan F Plan F+ Plan G Plan G+ Plan K Plan L 19 UnitedHealthcare Insurance Company (AARP Members) (UnitedHealth Group) 680 Blair Mill Road, Horsham, PA 19044; 1-800-523-5800 Pre-Existing Condition Limitations: Yes- Limitation provision is 3 months/3 months. Age Male Fem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem. 65 190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50 65 131.25131.25188.50188.50236.00236.00237.25237.25181.50181.5071.2571.25125.50125.50169.00169.00 66 142.50142.50204.50204.50255.75255.75257.25257.25197.00197.0077.2577.25136.25136.25183.50183.50 142.50142.50204.50204.50255.75255.75257.25257.25197.00197.0077.2577.25136.25136.25183.50183.50142.50142.50204.50204.50255.75255.75257.25257.25197.00197.0077.2577.25136.25136.25183.50183.50142.50142.50204.50204.50255.75255.75257.25257.25197.00197.0077.2577.25136.25136.25183.50183.50158.25158.25227.25227.25284.25284.25285.75285.75218.75218.7585.7585.75151.25151.25203.75203.75158.25158.25227.25227.25284.25284.25285.75285.75218.75218.7585.7585.75151.25151.25203.75203.75158.25158.25227.25227.25284.25284.25285.75285.75218.75218.7585.7585.75151.25151.25203.75203.75158.25158.25227.25227.25284.25284.25285.75285.75218.75218.7585.7585.75151.25151.25203.75203.75158.25158.25227.25227.25284.25284.25285.75285.75218.75218.7585.7585.75151.25151.25 203.75203.75174.00174.00250.00250.00312.75312.75314.25314.25240.75240.7594.2594.25166.50166.50224.25224.25174.00174.00250.00250.00312.75312.75314.25314.25
240.75240.7594.2594.25166.50166.50224.25224.25174.00174.00250.00250.00312.75312.75314.25314.25240.75240.7594.2594.25166.50166.50224.25224.25174.00174.00250.00250.00312.75312.75314.25314.25240.75240.7594.2594.25166.50166.50224.25224.25174.00174.00250.00250.00312.75312.75314.25314.25240.75240.7594.2594.25166.50166.50224.25224.25190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00 181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50 103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00 262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50 Plan L Plan M Plan N Notes:These plans are available to all New Hampshire Medicare recipients who are members of AARP. Discounts available for Multi-Insured (7%), Electronic Funds Transfer ($2.00 per household per month), and Annual Pay ($24 per household per year). Rates Effective January 1, 2021 Plan A Plan B Plan C Plan D Plan F Plan F+ Plan G Plan G+ Plan K 20 UnitedHealthcare Insurance Company (AARP Members) (UnitedHealth Group) 680 Blair Mill Road, Horsham, PA 19044; 1-800-523-5800 Pre-Existing Condition Limitations: Yes- Limitation provision is 3 months/3 months. Age Male Fem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem. 65 190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50 65 131.25131.25188.50188.50236.00236.00237.25237.25181.5
0181.5071.2571.25125.50125.50169.00169.00 66 142.50142.50204.50204.50255.75255.75257.25257.25197.00197.0077.2577.25136.25136.25183.50183.50 142.50142.50204.50204.50255.75255.75257.25257.25197.00197.0077.2577.25136.25136.25183.50183.50142.50142.50204.50204.50255.75255.75257.25257.25197.00197.0077.2577.25136.25136.25183.50183.50142.50142.50204.50204.50255.75255.75257.25257.25197.00197.0077.2577.25136.25136.25183.50183.50158.25158.25227.25227.25284.25284.25285.75285.75218.75218.7585.7585.75151.25151.25203.75203.75158.25158.25227.25227.25284.25284.25285.75285.75218.75218.7585.7585.75151.25151.25203.75203.75158.25158.25227.25227.25284.25284.25285.75285.75218.75218.7585.7585.75151.25151.25203.75203.75158.25158.25227.25227.25284.25284.25285.75285.75218.75218.7585.7585.75151.25151.25203.75203.75158.25158.25227.25227.25284.25284.25285.75285.75218.75218.7585.7585.75151.25151.25 203.75203.75174.00174.00250.00250.00312.75312.75314.25314.25240.75240.7594.2594.25166.50166.50224.25224.25174.00174.00250.00250.00312.75312.75314.25314.25240.75240.7594.2594.25166.50166.50224.25224.25174.00174.00250.00250.00312.75312.75314.25314.25240.75240.7594.2594.25166.50166.50224.25224.25174.00174.00250.00250.00312.75312.75314.25314.25240.75240.7594.2594.25166.50166.50224.25224.25174.00174.00250.00250.00312.75312.75314.25314.25240.75240.7594.2594.25166.50166.50224.25224.25190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00 181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50 103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.502
44.50190.00190.00272.75272.75341.00341.00343.00343.00 262.50262.50103.00103.00181.50181.50244.50244.50190.00190.00272.75272.75341.00341.00343.00343.00262.50262.50103.00103.00181.50181.50244.50244.50 Plan L Plan M Plan N Notes:These plans are available to all New Hampshire Medicare recipients who are members of AARP. Discounts available for Multi-Insured (7%), Electronic Funds Transfer ($2.00 per household per month), and Annual Pay ($24 per household per year). Rates Effective January 1, 2021 Plan A Plan B Plan C Plan D Plan F Plan F+ Plan G Plan G+ Plan K 21 USAA Life Insurance Company (United Service Automobile Assn Group) 9800 Fredericksburg Road, San Antonio, TX 78288; 1-800-531-8722 Pre-Existing Condition Limitations: None Age Male Fem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem.MaleFem. 65 213.86213.86284.75284.75278.97278.97222.87222.87 65 176.29176.29234.43234.43191.76191.76183.09183.09 66 176.29176.29234.43234.43191.76191.76183.09183.09 176.29176.29234.43234.43191.76191.76183.09183.09176.29176.29234.43234.43191.76191.76183.09183.09176.29176.29234.43234.43191.76191.76183.09183.09190.06190.06253.13253.13215.73215.73198.22198.22190.06190.06253.13253.13215.73215.73198.22198.22190.06190.06253.13253.13215.73215.73198.22198.22190.06190.06253.13253.13215.73215.73198.22198.22190.06190.06253.13253.13215.73215.73198.22198.22201.45201.45268.43268.43236.98236.98209.78209.78201.45201.45268.43268.43236.98236.98209.78209.78201.45201.45268.43268.43236.98236.98209.78209.78201.45201.45268.43268.43236.98236.98209.78209.78201.45201.45268.43268.43236.98236.98209.78209.78209.95209.95278.97278.97259.42259.42218.28218.28209.95209.95278.97278.97259.42259.42218.28 218.28209.95209.95278.97278.97259.42259.42218.28218.28209.95209.95278.97278.97259.42259.42218.28218.28209.95209.95278.97278.97259.42259.42218.28218.28213.86213.86284.75284.75278.97278.97222.87222.87213.86213.86284.75284.75278.97278.97222.87222.87213.86213.86284.75284.75278.97278.97222.87222.87213.86213.86284.75284.75278.97278.97222.87222.87213.86213.86284.75284.75278.97278.97222.87222.87213.86213.86284.75284.75278.97278.97222.87222.87213.86213.86284.75284.75278.97278.97222.87222.87213.86213.86284.75284.75278.97278.97222.87222.87213.86213.86284.75284.75278.97278.97222.87222.87213.86213.86284.75284.75278.97278.97222.87222.87213.86213.86284.75284.75278.97278.97222.87222.87213.86213.86284.75284.75278.97278.97 222.87222.87213.86213.86284.75284.75278.97278.97222.87222.87213.86213.86284.75284.75278.97278.97222.87222.87213.86213.86284.75284.75278.97278.97222.87222.87Notes: These forms are generally available to all Medicare recipients residing in New Hampshire. During open enrollment, policies are not subject to underwriting and pay non-smoker rates. Outside of open enrollment, policies may be subject to underwriting and may be charged smoker rates. No pre-existing condition limitations/exclusions apply. Quarterly rates are also available. Plan N Rates Effective January 1, 2021 Plan M Plan A Plan B Plan C Plan D Plan F Plan F+ Plan G Plan G+ Plan K Plan L 22