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CoventryOne Authorized Agent |
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$30 Copay Plan $3,500 Deductible** |
$35 Copay Plan $3,500 Deductible** |
$45
Copay $3,750 Deductible NoDrug Deductible** |
CoventryOne $45 Copay Plan $3,750 Ded with Rx Deductible |
Fusion 100%/50% $3,000 Deductible** |
$3,000 Single Ded. $5,000 Fam. Ded.** |
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| Age | Male | Female | Male | Female | Male | Female | Male | Female | Male | Female | Male | Female | Age |
| 0 | $217.79 | $217.79 | $164.59 | $164.59 | $152.48 | $152.48 | $134.53 | $134.53 | $251.95 | $251.95 | $237.19 | $237.19 | 0 |
| 1 | 132.15 | 132.15 | 98.77 | 98.77 | 91.50 | 91.50 | 80.73 | 80.73 | 135.20 | 135.20 | 142.31 | 142.31 | 1 |
| 2-5 | 85.18 | 85.18 | 69.16 | 69.16 | 64.07 | 64.07 | 56.53 | 56.53 | 75.24 | 75.24 | 94.05 | 94.05 | 2-5 |
| 6-16 | 85.18 | 85.18 | 69.16 | 69.16 | 64.07 | 64.07 | 56.53 | 56.53 | 75.23 | 75.23 | 94.05 | 94.05 | 6-16 |
| 17 | 83.20 | 89.46 | 67.55 | 72.06 | 62.58 | 66.76 | 55.22 | 58.90 | 75.23 | 80.13 | 91.87 | 96.33 | 17 |
| 18 | 81.22 | 93.67 | 65.95 | 74.89 | 61.09 | 69.38 | 53.90 | 61.21 | 75.23 | 82.93 | 89.68 | 98.30 | 18 |
| 19 | 79.24 | 96.23 | 64.34 | 76.61 | 59.60 | 70.98 | 52.59 | 62.62 | 75.23 | 82.93 | 87.49 | 100.91 | 19 |
| 20 | 71.25 | 97.33 | 54.10 | 79.30 | 50.12 | 73.46 | 44.22 | 64.82 | 75.56 | 97.60 | 77.60 | 100.09 | 20 |
| 21 | 72.05 | 101.50 | 54.71 | 79.30 | 50.68 | 73.46 | 44.72 | 64.82 | 76.40 | 107.80 | 78.47 | 110.54 | 21 |
| 22 | 72.87 | 104.09 | 55.33 | 79.30 | 51.26 | 73.46 | 45.22 | 64.82 | 77.27 | 110.55 | 79.36 | 113.37 | 22 |
| 23 | 73.44 | 109.09 | 55.77 | 83.09 | 51.66 | 76.98 | 45.58 | 67.92 | 77.89 | 115.86 | 79.99 | 118.80 | 23 |
| 24 | 74.02 | 114.08 | 56.19 | 86.90 | 52.06 | 80.50 | 45.93 | 731.03 | 78.50 | 118.63 | 80.62 | 124.24 | 24 |
| 25 | 77.89 | 119.00 | 59.32 | 89.34 | 54.95 | 82.76 | 48.48 | 73.02 | 83.10 | 123.25 | 84.83 | 129.60 | 25 |
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$30 Copay Plan $3,500 Deductible** |
$35 Copay Plan $3,500 Deductible** |
$45
Copay $3,750 Deductible NoDrug Deductible** |
CoventryOne $45 Copay Plan $3,750 Ded with Rx Deductible |
Fusion 100%/50% $3,000 Deductible** |
$3,000 Single Ded. $5,000 Fam. Ded.** |
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| Age | Male | Female | Male | Female | Male | Female | Male | Female | Male | Female | Male | Female | Age |
| 26 | 78.50 | 121.17 | 59.77 | 90.98 | 55.37 | 84.28 | 48.86 | 74.36 | 83.74 | 125.51 | 85.49 | 131.96 | 26 |
| 27 | 79.11 | 122.22 | 60.24 | 92.87 | 55.81 | 88.04 | 494.24 | 75.91 | 84.40 | 128.11 | 86.16 | 133.11 | 27 |
| 28 | 80.03 | 123.43 | 60.95 | 94.66 | 56.47 | 87.69 | 49.82 | 77.37 | 85.39 | 130.61 | 87.16 | 134.43 | 28 |
| 29 | 82.68 | 124.64 | 62.96 | 97.25 | 58.32 | 90.10 | 51.46 | 79.49 | 88.21 | 134.18 | 90.04 | 135.74 | 29 |
| 30 | 87.81 | 125.85 | 66.35 | 100.62 | 61.47 | 93.21 | 54.23 | 82.24 | 90.58 | 139.14 | 95.63 | 137.06 | 30 |
| 31 | 92.94 | 127.70 | 70.23 | 105.03 | 65.06 | 97.30 | 57.41 | 85.85 | 95.86 | 145.25 | 101.21 | 139.08 | 31 |
| 32 | 96.81 | 132.57 | 73.16 | 108.96 | 67.78 | 10094. | 59.80 | 89.06 | 99.86 | 150.67 | 105.43 | 144.38 | 32 |
| 33 | 98.10 | 137.87 | 74.13 | 110.43 | 68.67 | 102.30 | 60.59 | 90.26 | 101.19 | 152.71 | 106.84 | 150.15 | 33 |
| 34 | 99.39 | 143.18 | 75.10 | 112.40 | 69.57 | 104.13 | 61.39 | 91.87 | 102.52 | 155.42 | 108.24 | 155.94 | 34 |
| 35 | 102.67 | 148.64 | 78.03 | 113.34 | 72.29 | 105.00 | 63.78 | 92.64 | 108.57 | 157.22 | 111.82 | 161.88 | 35 |
| 36 | 107.52 | 152.31 | 81.73 | 115.30 | 75.71 | 106.81 | 66.80 | 94.24 | 113.69 | 159.93 | 117.10 | 165.88 | 36 |
| 37 | 112.27 | 154.25 | 85.32 | 116.77 | 79.04 | 108.17 | 69.74 | 95.44 | 118.71 | 161.96 | 122.27 | 167.99 | 37 |
| 38 | 117.61 | 157.47 | 89.40 | 119.21 | 82.82 | 110.44 | 73.07 | 97.44 | 124.36 | 165.36 | 128.08 | 171.50 | 38 |
| 39 | 122.51 | 160.06 | 93.11 | 121.17 | 86.26 | 112.25 | 76.11 | 99.04 | 127.73 | 168.07 | 133.42 | 174.31 | 39 |
| 40 | 125.85 | 167.14 | 95.72 | 125.77 | 88.68 | 116.52 | 78.24 | 102.80 | 136.83 | 185.42 | 137.06 | 182.03 | 40 |
| 41 | 130.69 | 169.63 | 99.41 | 127.64 | 92.09 | 118.25 | 81.25 | 104.33 | 142.08 | 188.19 | 142.33 | 184.74 | 41 |
| 42 | 134.00 | 172.78 | 101.92 | 130.04 | 94.42 | 120.47 | 83.31 | 106.29 | 145.68 | 191.68 | 145.94 | 188.18 | 42 |
| 43 | 138.68 | 175.60 | 106.61 | 132.14 | 98.76 | 122.42 | 87.14 | 108.01 | 150.77 | 194.81 | 151.04 | 191.25 | 43 |
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$30 Copay Plan $3,500 Deductible** |
$35 Copay Plan $3,500 Deductible** |
$45
Copay $3,750 Deductible NoDrug Deductible** |
CoventryOne $45 Copay Plan $3,750 Ded with Rx Deductible |
Fusion 100%/50% $3,000 Deductible** |
$3,000 Single Ded. $5,000 Fam. Ded.** |
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| Age | Male | Female | Male | Female | Male | Female | Male | Female | Male | Female | Male | Female | Age |
| 44 | 146.50 | 178.72 | 117.28 | 134.49 | 108.65 | 124.60 | 95.86 | 109.93 | 152.02 | 198.26 | 159.55 | 194.64 | 44 |
| 45 | 157.47 | 184.08 | 127.62 | 138.74 | 118.23 | 128.53 | 104.32 | 113.40 | 193.20 | 226.24 | 171.50 | 200.48 | 45 |
| 46 | 168.45 | 193.40 | 140.41 | 151.73 | 130.07 | 140.57 | 114.76 | 124.02 | 206.66 | 237.69 | 183.45 | 210.63 | 46 |
| 47 | 180.06 | 202.72 | 154.45 | 164.74 | 143.08 | 152.62 | 126.24 | 134.66 | 220.91 | 249.15 | 196.10 | 220.78 | 47 |
| 48 | 189.25 | 209.87 | 169.88 | 180.41 | 157.38 | 167.13 | 138.86 | 147.46 | 232.19 | 257.94 | 206.11 | 228.57 | 48 |
| 49 | 198.61 | 216.67 | 186.87 | 186.02 | 173.11 | 172.33 | 152.74 | 152.05 | 240.29 | 266.29 | 216.30 | 235.97 | 49 |
| 50 | 205.89 | 228.53 | 188.46 | 204.66 | 174.59 | 189.60 | 154.04 | 167.28 | 278.99 | 293.22 | 222.53 | 248.89 | 50 |
| 51 | 222.34 | 239.95 | 190.05 | 211.41 | 176.06 | 195.85 | 155.34 | 172.80 | 303.42 | 307.87 | 240.07 | 258.31 | 51 |
| 52 | 230.95 | 251.97 | 198.39 | 218.16 | 183.79 | 202.10 | 162.16 | 178.31 | 316.21 | 323.28 | 249.25 | 267.73 | 52 |
| 53 | 241.60 | 264.57 | 206.28 | 224.90 | 191.10 | 208.35 | 168.61 | 183.83 | 332.03 | 339.46 | 260.61 | 277.14 | 53 |
| 54 | 254.03 | 267.98 | 217.74 | 231.65 | 201.71 | 214.60 | 177.97 | 189.34 | 339.98 | 356.40 | 273.86 | 286.56 | 54 |
| 55 | 267.64 | 271.38 | 230.61 | 238.40 | 213.64 | 220.85 | 188.49 | 194.86 | 373.32 | 378.03 | 288.38 | 295.98 | 55 |
| 56 | 280.74 | 283.60 | 245.14 | 245.14 | 227.10 | 227.10 | 200.37 | 200.37 | 392.91 | 396.25 | 302.35 | 305.39 | 56 |
| 57 | 293.85 | 295.37 | 257.19 | 255.89 | 238.26 | 237.06 | 210.22 | 209.16 | 412.50 | 406.26 | 316.32 | 317.94 | 57 |
| 58 | 301.34 | 302.18 | 264.69 | 262.87 | 245.21 | 243.52 | 216.35 | 214.86 | 423.71 | 406.26 | 324.31 | 325.20 | 58 |
| 59 | 315.49 | 315.51 | 277.98 | 274.87 | 257.52 | 254.64 | 227.21 | 224.67 | 443.68 | 406.26 | 339.39 | 339.41 | 59 |
| 60 | 358.59 | 330.16 | 294.42 | 288.33 | 272.76 | 267.11 | 240.65 | 235.67 | 505.59 | 462.25 | 385.36 | 355.04 | 60 |
| 61 | 375.69 | 338.89 | 303.92 | 297.62 | 281.56 | 275.72 | 248.42 | 243.27 | 530.97 | 467.53 | 403.59 | 364.35 | 61 |
| 62 | 393.58 | 346.48 | 312.06 | 306.51 | 289.10 | 283.95 | 255.07 | 250.53 | 557.53 | 467.53 | 422.66 | 372.44 | 62 |
| 63 | 412.27 | 353.76 | 320.01 | 315.02 | 296.46 | 291.83 | 261.56 | 257.49 | 585.27 | 467.53 | 442.59 | 380.20 | 63 |
| Age | Male | Female | Male | Female | Male | Female | Male | Female | Male | Female | Male | Female | Age |
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$30 Copay Plan $3,500 Deductible** |
$35 Copay Plan $3,500 Deductible** |
$45
Copay $3,750 Deductible NoDrug Deductible** |
CoventryOne $45 Copay Plan $3,750 Ded with Rx Deductible |
Fusion 100%/50% $3,000 Deductible** |
$3,000 Single Ded. $5,000 Fam. Ded.** |
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| *CoventryOne monthly rates effective 8-1-11 to 9-30-11 are issued for illustrative purposes only. Rates are subject to change. Call for specific rates and availability. All applicants are subject to medical underwriting and approval by Coventry Health Care of Georgia, Inc. Refer to plan documents for a complete list of coverage, limitations and exclusions. | |||||||||||||
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5 Dunwoody Pk., Suite 113 Atlanta, GA 30338 |
(770) 396-9517 Outside of the Atlanta area, call toll-free: 1-877-711-8376. Email: holly@insurance-now.com |
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