PEBB Continuation Coverage premiums (Medicare)

Find out the monthly cost of your Medicare continuation coverage insurance plans.

Qualify for the Medicare rate

To qualify for the Medicare rate:

  1. At least one covered family member must be enrolled in both Medicare Part A and Part B. (Medicare rates are not available to continuation coverage members.)
  2. Medicare-enrolled subscribers in Kaiser Permanente NW's Senior Advantage plan or Kaiser Permanente WA's Medicare Advantage must complete and sign the Medicare Advantage Plan Election Form (Form C) to enroll in one of these plans.

Medical plan premiums

2019

Members enrolled in Part A and Part B of Medicare:

Kaiser Permanente NW Senior Advantage

Kaiser Permanente WA Medicare Plan

Kaiser Permanente WA Classic

Kaiser Permanente WA SoundChoice

Kaiser Permanente WA Value

UMP Classic

Subscriber only

$333.64

$329.85

N/A2

N/A2

N/A2

$481.09

Subscriber and spouse1
(1 Medicare eligible)

$1,038.323

N/A2

$1,057.27

$927.09

$980.13

$1,149.96

Subscriber and spouse1
(2 Medicare eligible)

$661.31

$653.73

N/A2

N/A2

N/A2

$956.20

Subscriber and child(ren)
(1 Medicare eligible)

$862.153

N/A2

$875.41

$777.78

$817.56

$982.74

Subscriber and child(ren)
(2 Medicare eligible)

$661.31

$653.73

N/A2

N/A2

N/A2

$956.20

Subscriber, spouse1, and child(ren)
(1 Medicare eligible)

$1,566.833

N/A2

$1,602.83

$1,375.01

$1,467.84

$1,651.62

Subscriber, spouse1, and child(ren)
(2 Medicare eligible)

$1,189.823

N/A2

$1,199.29

$1,101.66

$1,141.44

$1,457.86

Subscriber, spouse1, and child(ren)
(3 Medicare eligible)

$988.98

$977.61

N/A2

N/A2

N/A2

$1,431.32

1 or state-registered domestic partner

2 If a Kaiser Permanente WA subscriber is enrolled in Medicare Part A and Part B and covers a dependent who is not eligible for Medicare, the dependent must enroll in a Kaiser Permanente WA Classic or Value plan and the subscriber will pay a combined Medicare and non-Medicare rate.

3 If a Kaiser Permanente NW subscriber is enrolled in Medicare Part A and Part B and covers a dependent not eligible for Medicare, the dependent will be enrolled in Kaiser Permanente NW Classic. The subscriber will pay the combined Medicare and non-Medicare rate shown for Kaiser Permanente NW Senior Advantage.

2018

Members enrolled in Part A and Part B of Medicare: Kaiser Permanente NW Senior Advantage Kaiser Permanente WA Medicare Plan Kaiser Permanente WA Classic Kaiser Permanente WA SoundChoice Kaiser Permanente WA Value UMP Classic
Subscriber only $323.07 $325.40 N/A2 N/A2 N/A2 $483.64
Subscriber and spouse1
(1 Medicare eligible)
$1,010.713 N/A2 $1,038.77 $927.49 $953.90 $1,136.48
Subscriber and spouse1
(2 Medicare eligible)
$641.12 $645.78 N/A2 N/A2 N/A2 $962.26
Subscriber and child(ren)
(1 Medicare eligible)
$838.803 N/A2 $860.43 $776.97 $796.78 $973.27
Subscriber and child(ren)
(2 Medicare eligible)
$641.12 $645.78 N/A2 N/A2 N/A2 $962.26
Full family
(1 Medicare eligible)
$1,526.443 N/A2 $1,573.80 $1,379.06 $1,425.28 $1,626.11
Full family
(2 Medicare eligible)
$1,156.853 N/A2 $1,180.81 $1,097.35 $1,117.16 $1,451.89
Full family
(3 Medicare eligible)
$959.17 $966.16 N/A2 N/A2 N/A2 $1,440.88

1 or state-registered domestic partner

2 If a Kaiser Permanente WA subscriber is enrolled in Medicare Part A and Part B and covers a dependent who is not eligible for Medicare, the dependent must enroll in a Kaiser Permanente WA Classic or Value plan and the subscriber will pay a combined Medicare and non-Medicare rate.

3 If a Kaiser Permanente NW subscriber is enrolled in Medicare Part A and Part B and covers a dependent not eligible for Medicare, the dependent will be enrolled in Kaiser Permanente NW Classic. The subscriber will pay the combined Medicare and non-Medicare rate shown for Kaiser Permanente NW Senior Advantage.

Medicare Supplement Plan F premiums

Administered by Premera Blue Cross

2019

 

Plan F (age 65 or older, eligible by age)

Plan F (Under age 65, eligible by disability)

Subscriber only

$212.38 $361.03

Subscriber and spouse* (1 Medicare eligible)**

$887.23

$1,035.88

Subscriber and spouse* (2 Medicare eligible - 1 retired, 1 disabled)

$573.41

$573.41

Subscriber and spouse* (2 Medicare eligible)

$424.76

$722.06

Subscriber and child(ren) (1 Medicare eligible)**

$720.01

$868.66
Subscriber, spouse1, and child(ren) (1 Medicare eligible)** $1,388.88 $1,537.53
Subscriber, spouse1, and child(ren) (2 Medicare eligible - 1 retired, 1 disabled)** $1,081.04 $1,081.04
Subscriber, spouse1, and child(ren) (2 Medicare eligible)**

$932.39

$1,229.69

* or state-registered domestic partner

** If a Medicare supplement plan is selected, non-Medicare eligible dependents are enrolled in Uniform Medical Plan (UMP) Classic. The rates shown reflect the total due, including premiums for both plans.

2018

  Plan F (age 65 or older, eligible by age) Plan F (Under age 65, eligible by disability)
Subscriber only $212.38 $361.03
Subscriber and spouse* (1 Medicare eligible)** $870.24 $1,018.89
Subscriber and spouse* (2 Medicare eligible - 1 retired, 1 disabled) $573.41 $573.41
Subscriber and spouse* (2 Medicare eligible) $424.76 $722.06
Subscriber and child(ren) (1 Medicare eligible)** $707.03 $855.68
Full family (1 Medicare eligible)** $1,359.87 $1,508.52
Full family (2 Medicare eligible - 1 retired, 1 disabled)** $1,068.06 $1,068.06
Full family (2 Medicare eligible)** $919.41 $1,216.71

* or state-registered domestic partner

** If a Medicare supplement plan is selected, non-Medicare eligible dependents are enrolled in Uniform Medical Plan (UMP) Classic. The rates shown reflect the total due, including premiums for both plans.

Dental plan premiums (with medical plan)

2019

 

DeltaCare

Uniform Dental Plan Willamette Dental Group

Subscriber only

$39.53

$45.87 $44.45

Subscriber and spouse*

$79.06

$91.74 $88.90

Subscriber and child(ren)

$79.06

$91.74 $88.90

Subscriber, spouse1, and child(ren)

$118.59

$137.61 $133.35

2018

  DeltaCare Uniform Dental Plan Willamette Dental Group
Subscriber only $39.53 $45.82 $42.37
Subscriber and spouse* $79.06 $91.64 $84.74
Subscriber and child(ren) $79.06 $91.64 $84.74
Full family $118.59 $137.46 $127.11

* or state-registered domestic partner

Before you enroll

  1. Make sure you live in the plan's service area.
  2. Contact the plan or check the plan's provider directory to make sure your providers are in the plan's network.

Surcharges in addition to medical plan premiums

You will pay the following surcharges in addition to your medical plan premium if they apply to you.

  • A monthly $25-per-account premium surcharge will apply if you or any dependent (age 13 and older) enrolled in PEBB medical uses tobacco products.
  • A monthly $50 premium surcharge will apply if you enroll your spouse or state-registered domestic partner in PEBB medical and your spouse or state-registered domestic partner has chosen not to enroll in other employer-based group medical that is comparable to Uniform Medical Plan (UMP) Classic.

For more details, visit Surcharges.