Page 43 - Cover letter and evaluation for Paulina Rosenstein

2017 COMMUNITY RATED
PPLEMENT MONTHLY PREMIUMS
AS OF JANUARY 1, 2018)

ON NYC PROPER ROCHESTER SYRACUSE UTICA WATERTOWN WESTCHESTER
100-04 & 111-14 144-46 130-32 & 137-39 133-35 136
105-109
$99.74 $69.11 & 148-49 $69.11 $69.11
$127.00 $106.00 $106.00 $79.30
$142.00 $129.44 $69.11 $106.00 $129.44 $99.74
$189.20 $79.30 $127.00
$53.00 $129.44 $53.00
$76.50 $106.00 $53.00 $189.20
$61.50 $61.50
$129.44 $76.50

$53.00
$61.50

ON NYC PROPER ROCHESTER SYRACUSE UTICA WATERTOWN WESTCHESTER
100-04 & 111-14 144-46 130-32 & 137-39 133-35 136
105-109
$261.66 $180.79 & 148-49 $180.79 $180.79
$179.00 $149.00 $149.00 $207.72
$200.00 $184.53 $180.79 $149.00 $184.53 $261.66
$270.13 $110.25 $207.72 $110.25 $179.00
$184.53
$159.50 $149.00 $110.25 $270.13
$128.25 $128.25
$184.53 $159.50

$110.25
$128.25

n a part or all of the region. For more details on your exact premium, contact
ps://myportal.dfs.ny.gov/web/guest-applications/medicare-monthly-premiums