| Effective April 1, 2005 |
|
|
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| Los Angeles and Orange Counties |
 |
| (except for Los Angeles County zip codes |
 |
| 91711, 91759, 91765, 91766, 91767, 93535,
93544, 93563 and 93591) |
 |
| Age |
Plan A |
Plan B |
Plan C |
Plan D |
Plan F |
Plan H |
Plan I |
 |
| 65 to 66 |
$93 |
$98 |
$110 |
$104 |
$118 |
$241 |
$240 |
 |
| |
 |
| 67 to 69 |
$94 |
$100 |
$112 |
$106 |
$123 |
$262 |
$266 |
 |
| |
 |
| 70 to 74 |
$120 |
$134 |
$156 |
$149 |
$162 |
$302 |
$299 |
 |
| |
 |
| 75 to 79 |
$160 |
$164 |
$185 |
$168 |
$208 |
$359 |
$373 |
 |
| |
 |
| 80-plus |
$166 |
$172 |
$199 |
$178 |
$226 |
$411 |
$437 |
 |
| |
 |
| 64 or younger* |
$423 |
$633 |
$655 |
$561 |
$738 |
$862 |
$1,056 |
 |
|
| |
 |
 |
 |
| Riverside and San Bernardino Counties |
 |
| and the following zip codes in Los Angeles
County: |
 |
| 91711, 91759, 91765, 91766, 91767, 93535,
93544, 93563 and 93591 |
 |
| Age |
Plan A |
Plan B |
Plan C |
Plan D |
Plan F |
Plan H |
Plan I |
 |
| 65 to 66 |
$94 |
$101 |
$114 |
$108 |
$121 |
$242 |
$234 |
 |
| |
 |
| 67 to 69 |
$95 |
$103 |
$117 |
$111 |
$126 |
$254 |
$261 |
 |
| |
 |
| 70 to 74 |
$121 |
$138 |
$162 |
$156 |
$166 |
$295 |
$289 |
 |
| |
 |
| 75 to 79 |
$159 |
$167 |
$190 |
$175 |
$211 |
$326 |
$341 |
 |
| |
 |
| 80-plus |
$163 |
$174 |
$207 |
$185 |
$229 |
$374 |
$405 |
 |
| |
 |
| 64 or younger* |
$425 |
$638 |
$674 |
$567 |
$744 |
$798 |
$949 |
 |
|
| |
 |
 |
 |
| San Diego County |
 |
| Age |
Plan A |
Plan B |
Plan C |
Plan D |
Plan F |
Plan H |
Plan I |
 |
| 65 to 66 |
$94 |
$99 |
$110 |
$104 |
$118 |
$242 |
$234 |
 |
| |
 |
| 67 to 69 |
$95 |
$101 |
$114 |
$108 |
$124 |
$263 |
$261 |
 |
| |
 |
| 70 to 74 |
$121 |
$136 |
$157 |
$151 |
$161 |
$301 |
$283 |
 |
| |
 |
| 75 to 79 |
$160 |
$168 |
$184 |
$176 |
$205 |
$337 |
$347 |
 |
| |
 |
| 80-plus |
$169 |
$177 |
$201 |
$186 |
$222 |
$385 |
$421 |
 |
| |
 |
| 64 or younger* |
$440 |
$621 |
$622 |
$567 |
$744 |
$870 |
$1,056 |
 |
|
| |
 |
 |
 |
| Kern, Santa Barbara and Ventura Counties |
 |
| Age |
Plan A |
Plan B |
Plan C |
Plan D |
Plan F |
Plan H |
Plan I |
 |
| 65 to 66 |
$95 |
$100 |
$114 |
$106 |
$123 |
$232 |
$228 |
 |
| |
 |
| 67 to 69 |
$96 |
$102 |
$117 |
$109 |
$128 |
$254 |
$245 |
 |
| |
 |
| 70 to 74 |
$122 |
$138 |
$162 |
$154 |
$165 |
$301 |
$282 |
 |
| |
 |
| 75 to 79 |
$160 |
$170 |
$190 |
$180 |
$210 |
$342 |
$341 |
 |
| |
 |
| 80-plus |
$165 |
$177 |
$205 |
$190 |
$228 |
$396 |
$389 |
 |
| |
 |
| 64 or younger* |
$429 |
$585 |
$629 |
$598 |
$744 |
$830 |
$1,006 |
 |
|
| |
 |
 |
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| San Joaquin, Sonoma and Stanislaus Counties |
 |
| Age |
Plan A |
Plan B |
Plan C |
Plan D |
Plan F |
Plan H |
Plan I |
 |
| 65 to 66 |
$93 |
$94 |
$100 |
$95 |
$104 |
$202 |
$218 |
 |
| |
 |
| 67 to 69 |
$94 |
$96 |
$103 |
$98 |
$109 |
$228 |
$234 |
 |
| |
 |
| 70 to 74 |
$120 |
$127 |
$147 |
$134 |
$143 |
$254 |
$255 |
 |
| |
 |
| 75 to 79 |
$138 |
$149 |
$182 |
$160 |
$190 |
$302 |
$314 |
 |
| |
 |
| 80-plus |
$149 |
$159 |
$200 |
$170 |
$203 |
$353 |
$368 |
 |
| |
 |
| 64 or younger* |
$328 |
$516 |
$565 |
$426 |
$598 |
$684 |
$789 |
 |
|
| |
| |
| |
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 |
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| Alameda, Alpine, Amador, Butte, Calaveras,
Colusa, Contra Costa, Del Note, El Dorado, Fresno,
Glenn, Humboldt, Imperial, Inyo, Kings, Lake,
Lassen, Madera, Marin, Mariposa, Mendocino,
Merced, Modoc, Mono, Monterey, Napa, Nevada,
Placer, Plumas, Sacramento, San Benito, San
Francisco, San Luis Obispo, San Mateo, Santa
Clara, Santa Cruz, Shasta, Sierra, Siskiyou,
Solano, Sutter, Tehama, Trinity, Tulare, Tuolomne,
Yolo and Yuba Counties |
 |
| Age |
Plan A |
Plan B |
Plan C |
Plan D |
Plan F |
Plan H |
Plan I |
 |
| 65 to 66 |
$90 |
$91 |
$98 |
$93 |
$102 |
$204 |
$207 |
 |
| |
 |
| 67 to 69 |
$92 |
$93 |
$99 |
$94 |
$106 |
$231 |
$224 |
 |
| |
 |
| 70 to 74 |
$115 |
$124 |
$142 |
$134 |
$140 |
$257 |
$245 |
 |
| |
 |
| 75 to 79 |
$136 |
$149 |
$182 |
$162 |
$192 |
$307 |
$299 |
 |
| |
 |
| 80-plus |
$147 |
$160 |
$198 |
$173 |
$201 |
$356 |
$358 |
 |
| |
 |
| 64 or younger* |
$315 |
$485 |
$535 |
$380 |
$598 |
$642 |
$789 |
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