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2010 Medicare Supplement and Medicare Select Rates*
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Senior Gold (Medicare Select)
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Tobacco-Free Rate
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Standard Rate
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Senior Gold
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$194
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$256
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+ optional Preventive Care Coverage
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$5
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$5
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Senior Gold (w/ Preventive)
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$199
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$261
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Basic Medicare Blue
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Tobacco-Free Rate
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Standard Rate
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Basic (w/ no riders)
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$134
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$156
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+ optional Part A Deductible Coverage
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$70
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$81
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+ optional Part B Deductible Coverage
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$11
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$11
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+ optional Remaining Charges Coverage* (up to 100% of Usual and Customary Charges)
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$30
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$45
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+ optional Preventive Care Coverage
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$5
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$5
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Basic (w/ all riders & Preventive)
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$250
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$298
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Extended Basic Blue
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Tobacco-Free Rate
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Standard Rate
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Extended Basic Blue
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$447
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$562
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*If your effective date of coverage is June 1, 2010 or later, premiums may be different.
Plan premiums are subject to change each calendar year regardless of your effective date. Contact your sales representative or Blue Cross for additional information.
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