Medicare supplement plan premiums If a Medicare supplement plan is selected, non-Medicare members are enrolled in UMP Classic. The rates shown re昀氀ect the total due, including premiums for both plans. Note: These Medicare premiums do not include your Medicare Part B premium. Premera Blue Cross Plan F (closed to new members) Plan G Age 65 or older, Under age 65, Age 65 or older, Under age 65, eligible by age eligible by disability eligible by age eligible by disability Subscriber only 1 Medicare eligible $232.14 $390.45 $198.02 $332.45 Subscriber and spouse 1 Medicare eligible $1,057.86 $1,216.17 $1,023.74 $1,158.17 2 Medicare eligible: 1 retired, 1 disabled $616.63 $616.63 $524.51 $524.51 2 Medicare eligible $458.32 $774.94 $390.08 $658.94 Subscriber and children 1 Medicare eligible $851.43 $1,009.74 $817.31 $951.74 Subscriber, spouse, and children 1 Medicare eligible $1,677.15 $1,835.46 $1,643.03 4