*Authorized
independent agent/agency for Blue Cross
and Blue Shield of Minnesota. |
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Determine your monthly rate
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What you need to apply today
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Simply Blue SM Rates - (effective
April 1, 2011 through March 31, 2012.) |
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Preferred rates - without substance abuse
coverage Area 1 |
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Area 1
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Area 2 |
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without
substance abuse coverage
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including substance abuse
coverage
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without substance abuse
coverage
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including substance abuse
coverage |
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Coinsurance
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Prescription drug option 1
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Prescription drug option 2 |
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100/0%
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100/0% |
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Deductible
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$3,000
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$6,000
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$9,000
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$3,000
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$6,000
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$9,000
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Subscriber age
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| 19 29
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$111.50
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$95.00
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$85.00
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$103.00
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$88.50
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$75.50
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| 30 34
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$122.50
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$104.50
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$93.50
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$113.50
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$97.50
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$83.00
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| 35 39
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$127.00
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$108.50
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$97.00
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$117.50
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$101.00
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$86.00
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| 40 44
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$141.50
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$120.50
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$108.00
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$131.00
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$112.50
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$95.50
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| 45 49
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$175.00
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$149.00
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$133.00
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$161.50
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$139.00
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$118.00
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| 50 54
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$229.00
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$195.00
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$174.50
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$212.00
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$182.00
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$154.50
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| 55 59
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$288.00
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$245.00
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$219.00
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$266.00
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$228.50
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$194.50
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| 60 64
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$317.00
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$270.00
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$241.50
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$293.00
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$252.00
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$214.00
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These rates
are effective April 1, 2011 through March 31, 2012.
Rates are subject to benefit changes mandated by law and
annual adjustments. Applicants must be ages 19 to 64 to
be eligible for coverage. Note: Your rate will change
when you age into a new category or move into a
different rate area |
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Your
monthly rate is based on your age, deductible amount and
whether you choose substance abuse coverage.
Follow these simple steps to determine your rate
- Decide whether you want coverage for
substance abuse.
Select which chart applies and go to step two.
- Decide whether you want
Rx Option 1 or Rx Option 2.
Select the appropriate chart.
- Select your deductible.
This is the amount you pay before your plan pays.
- Find your age group on the left side of
the table.
Your rate will be the box where your age group and
deductible choice intersect.
Note: Your rate will change when you
age into a new category for example, from age 39 to 40
and on annual renewal dates (April 1). GoBlue rates
are subject to benefit changes mandated by law.
These tables show preferred rates. Standard rates, which
are 30% higher, are offered to users of tobacco or
smokeless tobacco as well as individuals with other
health factors.
These rates are effective September 23, 2010 through
March 31, 2011. Each adult subscriber must select a rate
based on his or her age. Applicants must be age 19 to 64
to be eligible for coverage. |
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