Gateway Accident & Health Insurance Plans: Gateway USA / Rates

Premium Rates Per Person

Medical Expense Maximum	Plan A: $50,000		Plan B: $100,000
Adult Rates: Age	15 Days only⁽¹⁾	Monthly	15 Days only⁽¹⁾	Monthly
18-29	$30	$49	$40	$66
30-39	$38	$64	$53	$88
40-49	$55	$92	$77	$128
50-59	$75	$126	$100	$168
60-69	$93	$155	$124	$206
70-79	$108	$185	N/A	N/A
80 and over ⁽²⁾	$165	$275	N/A	N/A
Child Rates (for child(ren) under age 18):
Each Dependent Child	$16	$26	$20	$34
Each Child Alone⁽³⁾	$25	$42	$40	$60
$100,000 Additional AD&D
(Optional)⁽⁴⁾	$9	$14	$9	$14

⁽¹⁾Minimum Term of Insurance is 15 days, maximum is 12 months. For any Term of Insurance more than 15 days, full Monthly rates apply.

⁽²⁾Medical Expense Maximum for ages 80 and over is $10,000.

⁽³⁾Use these rates for child(ren) who are insured independently and are not included with parent(s) on this Application.

⁽⁴⁾Available only to persons age 18 and older. If purchased, must be included for both Insured and Spouse, if applicable.