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LifeWise Health Plan of WA - Online
Application
Index | Exclusions
& Limitations | Provider
List | Download Application
Benefit Schedules:
WiseEssentials Rx | WiseEssentials Copay | WiseSimplicity | WiseChoices
Prime | WiseSavings
Rate Schedules:
WiseEssentials Rx | WiseEssentials Copay | WiseSimplicity | WiseChoices
Prime | WiseSavings
WiseChoices Prime Rates
Effective date : 1/1/2010
Valid thru : 12/31/2010
Counties :
Available in all counties
| Family Status : |
Applicant
Non-Smoker |
Applicant
Smoker |
| Age |
Deductible : 1500 |
| 0-24 |
177.00 |
207.00 |
| 25-29 |
201.00 |
233.00 |
| 30-34 |
231.00 |
268.00 |
| 35-39 |
277.00 |
322.00 |
| 40-44 |
324.00 |
380.00 |
| 45-49 |
408.00 |
471.00 |
| 50-54 |
499.00 |
581.00 |
| 55-59 |
581.00 |
674.00 |
| 60-64 |
661.00 |
774.00 |
| 65+ |
661.00 |
774.00 |
| Child |
149.00 |
149.00 |
| Age |
Deductible : 3000 |
| 0-24 |
150.00 |
175.00 |
| 25-29 |
170.00 |
197.00 |
| 30-34 |
195.00 |
226.00 |
| 35-39 |
234.00 |
272.00 |
| 40-44 |
274.00 |
321.00 |
| 45-49 |
345.00 |
398.00 |
| 50-54 |
422.00 |
491.00 |
| 55-59 |
491.00 |
569.00 |
| 60-64 |
558.00 |
653.00 |
| 65+ |
558.00 |
653.00 |
| Child |
126.00 |
126.00 |
* - not all of the zip codes are eligible in this county
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Assurant Health
