Monthly Premiums
Health WiseHealth Wise Plus
Direct Pay Drug coverage maximum of $1,200 per calendar yearSingle$94.00$115.00
Couple$183.50$225.50
Family$222.50$273.00
Direct Pay Drug coverage maximum of $2,000 per calendar yearSingle$131.00$152.00
Couple$258.00$300.00
Family$311.00$361.50
  • Under Age 75
  • Age 75 to 84
  • Age 85 and Over
Monthly Premiums
Total HealthUltimate Health
Direct Pay Drug coverage maximum of $1,200 per calendar yearSingle$112.75$133.75
Couple$220.50$262.50
Family$263.00$313.75
Direct Pay Drug coverage maximum of $2,000 per calendar yearSingle$149.25$170.25
Couple$294.25$336.00
Family$352.00$402.25
Monthly Premiums
Total HealthUltimate Health
Direct Pay Drug coverage maximum of $1,200 per calendar yearSingle$159.75$181.00
Couple$314.25$356.50
Family$378.75$429.50
Direct Pay Drug coverage maximum of $2,000 per calendar yearSingle$200.00$220.75
Couple$395.50$437.00
Family$477.75$527.25
Monthly Premiums
Total HealthUltimate Health
Direct Pay Drug coverage maximum of $1,200 per calendar yearSingle$299.50$320.50
Couple$593.00$635.25
Family$719.25$770.00
Direct Pay Drug coverage maximum of $2,000 per calendar yearSingle$348.50$369.75
Couple$691.75$734.50
Family$837.75$889.00
  • Under Age 75
  • Age 75 to 84
  • Age 85 and Over
Annual Premiums
Additional days for a single trip (over 92-day base travel included with the Total Health and Ultimate Health options)Under age 75
SingleCoupleFamily
15 (total days: 107)$213$426$449
30 (total days: 122)$456$912$1,044
45 (total days: 137)$638$1,276$1,486
60 (total days: 152)$833$1,667$1,963
75 (total days: 167)$1,046$2,092$2,482
90 (total days: 182)$1,272$2,544$3,035
105 (total days: 197)$1,514$3,028$3,625
120 (total days: 212)$1,772$3,544$4,254
Annual Premiums
Additional days for a single trip (over 92-day base travel included with the Total Health and Ultimate Health options)Age 75 to 84
SingleCoupleFamily
15 (total days: 107)$406$812$990
30 (total days: 122)$872$1,744$2,128
45 (total days: 137)$1,221$2,442$2,980
60 (total days: 152)$1,598$3,196$3,898
75 (total days: 167)$2,005$4,010$4,893
90 (total days: 182)$2,442$4,884$5,959
105 (total days: 197)$2,910$5,820$7,102
120 (total days: 212)$3,412$6,826$8,326
Annual Premiums
Additional days for a single trip (over 92-day base travel included with the Total Health and Ultimate Health options)Age 85 and over
SingleCoupleFamily
15 (total days: 107)$1,100$2,200$2,685
30 (total days: 122)$2,360$4,720$5,758
45 (total days: 137)$3,303$6,606$8,060
60 (total days: 152)$4,325$8,650$10,553
75 (total days: 167)$5,426$10,852$13,238
90 (total days: 182)$6,607$13,214$16,120
105 (total days: 197)$7,874$15,748$19,212
120 (total days: 212)$9,234$18,468$22,530
Monthly Premiums
Option AOption BOption C
Single$66.25$53.50$40.25
Couple$132.75$106.50$80.50
Family$157.75$127.00$96.00