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Medicare Supplement Insurance Rate Plan F

Plan Index

The following Table (Plan F) shows the Regions across the Top Row, the first three digits of the Zip Code across the Second Row and the insurers' names down the first Column. The Monthly Premiums for December 1, 2012 are contained in the body of the Table.

P L A N   FALBANYBUFFALOLONG ISLANDMID-HUDSONNYC PROPERROCHESTERSYRACUSEUTICAWATERTOWNWESTCHESTER

FIRST THREE DIGITS OF ZIP CODE:

120-23
128-29		140-43
147		110,115-19124-27100-04
111-14		144-46130-32
137-39
148-49		133-35136105-109

Aetna Life Insurance

$259.26

$224.97
$248.98

$345.02

$286.72

$345.02

$224.97
$248.98

$224.97
$248.98

$224.97
$248.98

$248.98

$345.02

American Progressive

$368.38*

$333.42*

$417.43*

$368.38*

$417.43*

$333.42*

$333.42*

$333.42*

$333.42*

$417.43*

Bankers Conseco

$324.00

$281.91

$408.27

$324.00

$408.27

$281.91

$281.91
$324.00

$281.91

$281.91

$324.00
$408.27

CDPHP Universal Benefits Inc.

$139.87

 

 

$159.84

 

 

$130.02

$132.27

 

 

EmpireHealthChoice Assurance
(d/b/a Empire BC (Albany Region) &

Empire BC/BS (All Other Regions))

$221.04

 

$294.73

$253.46

$294.73

 

 

 

 

$294.73

Excellus Health Plan, Inc.
(d/b/a Excellus BlueCross BlueShield)

$231.43**

 

 

$231.43**

 

$217.40
$239.25

$217.40
$231.43
$239.25

$231.43

$231.43

 

Excellus Health Plan, Inc.
(d/b/a Univera Healthcare)

 

$256.07

 

 

 

$256.07

$256.07

 

 

 

First United American

$266.00

$266.00

$325.00

$266.00

$325.00

$266.00

$266.00

$266.00

$266.00

$325.00

Group Health Incorporated
(a/k/a GHI)

$264.93

$250.59

$276.24

$264.93

$276.24

$250.59

$259.00

$250.59

$250.59

$276.24

HealthNow New York Inc.

 

 

 

$275.78****

 

$230.78

$230.78***

$230.78***

 

$275.78****

HealthNow New York Inc.
(d/b/a BC/BS of Western New York)

 

$230.78

 

 

 

$230.78

$230.78†

 

 

 

HealthNow New York Inc.
(d/b/a BS of Northeastern New York)

$234.52***

 

 

$234.52‡

 

 

 

$234.52***

 

 

Humana

$208.70

$208.70

$305.63

$208.70
$258.81

$305.63

$208.70

$208.70

$208.70

$208.70

$305.63

Mutual Of Omaha

$301.70
$318.93

$301.70
$318.93

$401.60

$318.93

$401.60

$301.70

$301.70

$301.70

$301.70

$318.93
$401.60

State Farm Mutual Auto

$403.93
$419.96

$403.93

$435.99

$419.96

$435.99

$403.93

$403.93

$403.93

$403.93

$435.99

Sterling Life

$245.84
$261.59

$245.84
$249.24
$261.59

$342.00

$245.84
$261.59
$342.00

$342.00

$245.84
$261.59

$245.84
$249.24

$245.84
$249.24
$261.59

$245.84

$342.00

UnitedHealthcare
(AARP Program)

$173.25
$201.50

$173.25

$250.75

$201.50

$250.75

$173.25

$173.25
$201.50

$173.25
$201.50

$173.25

$201.50
$250.75

*   There is a one-time $25 policy fee charged at issue.
** Excellus offers this plan in Clinton, Delaware, Essex, Fulton, and Montgomery counties.
*** HealthNow does not offer this plan in the following counties: Delaware, Franklin, Hamilton, Herkimer, Lewis, Otsego, Rockland, St. Lawrence, & Westchester
**** HealthNow offers this plan in Dutchess, Orange, Putnam, Sullivan, & Ulster counties.
† Offered in Allegany County, areas with 148 as first 3 digits of zip code
‡ Offered in Albany, Columbia, & Greene counties, areas with 124-127 as first 3 digits of zip code

NOTE:  If two premiums are shown within a region, one of the premiums applies to a part of the region and the other applies to the rest of the region.