2012 plan information

Body Mass Index

Find your Body Mass Index

Find your Body Mass Index, or BMI, by finding your height in the far left column, then matching your height with your approximate weight in pounds. Your BMI is at the top of that column. If your BMI is not on the BMI chart because it is less than 15 or greater than 40, you're in Tier 3.

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Body Mass Index (BMI) table
Tier Tier 2 Tier 1 Tier 2 Tier 3
BMI 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40
HeightYour Weight in Pounds
4'107274777982858790939699102105134139143148153158163167173177182186191
4'11"747784899499104109114119124128133138143148153158163169173179183189193198
5'0"7779879297102107112118123128133138143148153158163168174179184189194199204
5'1"79829095100106111116122127132137143148153158164169174180185190195201206211
5'2"82859398104109115120126131136142147153158164169175180186191196202207213218
5'3"858796102107113118124130135141146152158163169175180186191197203208214220225
5'4"879099105110116122128134140145151157163169174180186192197204209215221227232
5'5"9093102108114120126132138144150156162168174180186192198204210216222228234240
5'6"9396105112118124130136142148155161167173179186192198204210216223229235241247
5'7"9699109115121127134140146153159166172178185191198204211217223230236242249255
5'8"99102112118125131138144151158164171177184190197203210216223230236243249256262
5'9"102105115122128135142149155162169176182189196203209216223230236243250257263270
5'10"105108118125132139146153160167174181188195202209216222229236243250257264271278
5'11"108112122129136143150157165172179186193200208215222229236243250257265272279286
6'0"111115125133140147154162169177184191199206213221228235242250258265272279287294
6'1"114118129136144151159166174182189197204212219227235242250257265272280288295302
6'2"117121132140148155163171179186194202210218225233241249256264272280287295303311
6'3"120125136144152160168176184192200208216224232240248256264272279287295303311319
6'4"123128140148156164172180189197205213221230238246254263271279287295304312320 328

MyBlue Medigap offers access to any hospital, doctor or other health care provider in the U.S. or its territories that accepts Medicare assignment. The plan does not require members to use a specified provider network. MyBlue Medigap is a Medigap plan administered by Blue Care Network. Certain factors may affect the monthly premium cost: geographic location of the applicant’s residence, age, gender, height, weight and whether the applicant uses tobacco. Neither Blue Care Network nor agents authorized to sell Blue Care Network policies are connected with Medicare.

page modified 12/08/2011