Potential government shutdown

In the event of a federal government shutdown, individuals enrolled in Apple Health (Medicaid), Public Employees Benefits Board, and School Employees Benefits Board coverage—and those accessing behavioral health services—will not experience a disruption in care. In addition, health care providers will continue to be paid for the services they provide.

If a shutdown occurs, we will share more information at that time.

Retiree engagement

We want to know what retirees like about the Public Employees Benefits Board (PEBB) Medicare medical plans and what could be better. The insights our members provide will help HCA and the PEB Board shape future policy discussions as well as how we communicate important information about changes.

Prepare for open enrollment

Open enrollment is November 1 through 30, 2023. We've put together some tips to help you prepare. See what's changing for 2024. Many medical plan premiums are increasing significantly for 2024. Read the important information from the PEBB Program about retiree premiums. 

How is HCA connecting with retirees?

HCA hosted retiree listening sessions (19 online and four in-person) and three public forums, inviting retirees to talk about PEBB Medicare plans and the care provided for themselves and their dependents. Retirees enrolled in any of the PEBB Medicare plans are invited. From cost to coverage, your voice can make a difference. 

How will feedback be used? 

HCA is committed to providing quality customer service to our members. We want to improve how we provide important information about benefits and changes. We will use feedback we receive during these sessions to: 

  • Ensure our communication materials better meet our members' needs. 
  • Report to the PEB Board to help guide future benefit designs and proposals. 
  • Inform HCA and the plans on how we can better serve our members. 

Why are we doing retiree engagement?

In 2022, HCA expressed concern to the PEB Board about the rapidly rising UMP Classic Medicare premiums. Based on member feedback, the decision was made to keep UMP Medicare as a plan option. The PEB Board resolved to review this no sooner than 2024, however, the current HCA leadership has committed to taking no action on closing UMP Classic Medicare for the foreseeable future. 

Actions HCA has taken

Letter to Washington State Congressional Delegation members

Read the letter that was sent by HCA Director Sue Birch on June 15 to all Washington Congressional Delegation (Senators and Representatives). This letter alerted our Congressional Delegation of the issue with Uniform Medical Plan Classic Medicare not being eligible for federal subsidies and is asking them for their help. 

PEB Board meeting presentations

Throughout the 2023 PEB Board season, there were Medicare update presentations. Presentation topics have included: 

  • February 2023
    Medicare review, key differences between commercial UnitedHealthcare plans, and PEBB's, pre-enrollment outreach efforts, Stakeholders' Medicare Coalition, correspondence, Medicare appeals processes, HCA's role in prior authorization requests, and proposed CMS Medicare Advantage rules.
  • March 2023
    Open enrollment issues with UnitedHealthcare files, update on comments submitted to CMS, and Stakeholders’ Medicare Coalition listening session pilot.
  • April 2023
    Medicare review – IRMAA, CAHPS survey information, listening sessions recap, and public forums.
  • May 2023
    Pharmacy appeals processes, CAHPS survey information update, listening sessions and public forums recap, and retiree communications update.
  • June 8, 2023
    Listening sessions and public forums recap and retiree communications update. There was also a Coordination of Benefits (COB) State Analysis presentation. 
  • June 29, 2023
    Agency activities related to Medicare offerings, Congressional Delegation letter, and upcoming agency activities.
Participate

The PEB Board sets eligibility requirements, approves medical and dental plans, and approves the plans that provide health benefits to 222,000 public employees and retirees. The members are appointed by the Governor and represent a wide range of members and expertise.

The PEB Board meets from February to July to discuss PEBB benefits. Their meetings are open to the public. 

Learn more about the PEB Board and sign up for PEB Board meeting notices.

FAQs

Have a question not listed below? Email HCA PEBB Medicare.

Is UMP Classic Medicare closing?

No, this plan is not closing. There was discussion of closing the plan at a PEB Board meeting during the summer of 2022, but the proposal was not supported by the Board. Read more about UMP Classic Medicare.

If I enroll in a PEBB Medicare Advantage plan, can I enroll in a different PEBB plan later? 

Yes. You can change to any PEBB Medicare plan for which you are eligible during the annual open enrollment period.

You can also change your medical plan during a special open enrollment if you have a qualifying life event such as getting married or moving out of a plan’s coverage area.

I'm a Medicare retiree. Where can I find a comparison of PEBB plans available to me?

View the PEBB Medicare Benefits Comparison and Dental Benefits Comparison to compare coverage by plans side-by-side. 

You can find the month premiums in the 2023 Retiree monthly premiums

Is UMP Classic Medicare the only Medicare plan that is available statewide and nationwide?

No. Premera Medicare Supplement Plan F (no longer accepting new members) and Plan G and UnitedHealthcare PEBB Complete and PEBB Balance are available statewide and nationwide.

How are UMP, HCA, PEBB, SEBB, and Regence related?

Uniform Medical Plan (UMP) is a medical plan offered through HCA's Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) Programs. UMP Is administered by Regence BlueShield (for medical benefits) and Washington State Rx Services (for prescription drug benefits).

Will my prescription drugs be covered by PEBB Medicare plans, and at what cost? 

Each medical plan’s formulary (list of covered prescription drugs) and cost-sharing varies. However, there are similarities in the coverage provided by each plan. The exceptions are Medicare Supplement Plan F (no longer accepting new members) and Plan G, which do not provide prescription drug coverage. Call the medical plans or visit their websites for more information.

If I am in Uniform Medical Plan (UMP), do I have to be in Uniform Dental Plan (UDP)? 

No. The plans are separate and administered by difference insurance companies. 

  • Uniform Medical Plan is administered by Regence. 
  • Uniform Dental Plan is administered by Delta Dental of Washington.

If you want to be in UMP and Willamette Dental, that is ok. If you want to be in UMP and enrolled in DeltaCare, that is ok. Similarly, you can be enrolled in Uniform Dental Plan with any medical plan. 

Are Delta Dental plans available out of state? 

There are two dental plans administered by Delta Dental of Washington, DeltaCare and Uniform Dental Plan.

  • DeltaCare has no coverage outside of Washington State.
  • Uniform Dental Plan has coverage both within Washington State and nationwide, and emergency dental care is covered outside of the U.S.

Visit Dental plans and benefits or use the Dental Benefits Comparison to compare dental plans and Benefits while traveling to see how to get care while traveling.

Is Fred Hutchinson/Seattle Cancer Care Alliance in network for UnitedHealthcare?

Yes, Fred Hutchinson is part of the UnitedHealthcare network.

Medicare myths

Myth: If I sign up for a Medicare Advantage plan through PEBB and I want to go back to Original Medicare, I will be subject to pre-existing conditions or underwriting limits.

Fact: If you are in PEBB, you can switch from any Medicare plan (Original Medicare, Medicare Advantage Prescription Drug, or Medicare Supplement) to any other PEBB Medicare plan for which you are eligible. 

Original Medicare

Medicare Advantage

Medicare Advantage Prescription Drug (MAPD)

Medicare Supplement

Myth: UMP Classic Medicare is a Medicare Supplement plan.

Fact: UMP Classic Medicare is a coordination of benefits (COB) plan. This means that Medicare Part A and Part B pay first for medical services and UMP pays second for the services. If the service is not covered at all by Medicare, UMP pays primary. 

Medicare Supplement plans are often called "Medigap" plans, since they cover just the 20 percent of medical costs not covered by Medicare. 

PEBB's Medicare Supplement plans are offered by Premera and are Plan F (no longer accepting new members) and Plan G

Myth: I've been in my plan for years, so I don't have to pay attention to what PEBB offers.

Fact: Every year PEBB works with the carriers to update plan benefits and premiums. It's a good idea to check and see if there are any changes. In fact, there may be new plan offerings since you first enrolled that you may not be aware of.

Myth: My brother has a Medicare Advantage plan with a $0 premium. That's a much better deal than anything I could get through PEBB.

Fact: While there may be plans on the commercial market that have a $0 premium, those plans come with limitations and designs that are less desirable than the PEBB plans. 

For example, the commercial plan might be with a limited network (known as an HMO) that prevents you from seeing doctors outside the network. The maximum limit on what you might have to spend out-of-pocket might be very high with a commercial plan. 

When comparing plans, it is important to consider costs such as copays and deductibles in addition to the premium. Compare PEBB Medicare plans and view retiree monthly premiums.

Myth: All Medicare Advantage plans are the same.

Fact: Medicare Advantage plans offered by PEBB are Employer Group Medicare Advantage plans. These are different from commercial (individual) plans. 

PEBB Plans can offer lower premiums and better benefits, troubleshooting through PEBB, and expanded prescription drug coverage.

Myth: If a plan costs less it must not be able to offer the same coverage.

Fact:

  • Some plans may have lower premiums but much higher copays or limits on out-of-pocket expenses. 
  • Medicare Advantage plans receive federal subsidies, which lower premiums.
  • HMO plans control costs through network restrictions but still provide comprehensive coverage.

When comparing costs, it is important to look at all aspects – premiums, copays, and out-of-pocket costs. Compare PEBB Medicare plans and view retiree monthly premiums.

Myth: PEBB has no information about what you need to do when you plan to retire.

Fact: PEBB offers monthly webinars about retirement planning. 

There is also information about planning for retirement and signing up for Medicare, although some members are already enrolled in Medicare when they retire. 

You can also visit the Department of Retirement Systems (DRS) website, which offers webinars too. 

Myth: I need a separate Medicare drug plan to be on any of the PEBB Medicare plans

Fact: Medicare requires enrollment in a Part D plan (or comparable drug coverage, referred to as "creditable drug coverage") when you are eligible. 

Except for Medicare Supplement Plan F (no longer accepting new members) and Plan G, all PEBB Medicare plans provide this coverage. If you enroll in Plan G, you must purchase a standalone Medicare Part D plan from the commercial market. 

Myth: UMP doesn't provide vision or hearing benefits.

Fact: Except for Medicare Supplement Plan F and Plan G, all the PEBB Medicare plans provide vision and hearing coverage. Compare PEBB Medicare plans and view retiree monthly premiums.

Contact

The PEBB Program
For questions about eligibility, enrollment, and premiums.
Send a secure message
Phone: 1-800-200-1004, Monday through Friday, 8 a.m. to 4:30 p.m.
TRS: 711

The plans
For questions about plan-specific benefits and providers.