In crisis?
2019 PEBB open enrollment has begun. You have until November 30, 2018 to make changes to your coverage.
Kaiser Permanente NW plans
Kaiser Foundation Health Plan of the Northwest, with plans offered in Clark and Cowlitz counties in Washington and select counties in Oregon.
On this page
What are my plan options?
In general, PEBB retirees may choose from the plans listed below. Your options are limited to the plans available in your county and whether you are enrolled in Medicare Part A and Part B. Remember, if you cover eligible dependents, everyone must enroll in the same medical plan (with some exceptions, based on eligibility for Medicare Part A and Part B).
Non-Medicare
- Kaiser Permanente NW Classic
- Kaiser Permanente NW Consumer-Directed Health Plan (CDHP)
Medicare
- Kaiser Permanente NW Senior Advantage
Learn more about the plans.
How do I enroll?
To enroll in a Kaiser Permanente NW medical plan, you need to complete the following forms:
- Retiree Coverage Election/Change form (form A)
- Medicare Advantage plan election form (form C) - only if you are enrolling in Kaiser Permanente NW Senior Advantage
Do you need help completing the Retiree Coverage Election/Change form (form A)? Download instructions.
How do I find a provider?
Visit one of Kaiser Permanente NW's online provider directories.
What are the full benefits of each plan?
The following documents—called a Certificate of Coverage—provide in-depth descriptions of the health care benefits for each plan. For a summary of benefits and costs, see Is there a quick way to see benefits and costs?
Certificates of Coverage: non-Medicare
2018
2019
Certificates of Coverage: Medicare
2018
2019
Is there a quick way to see benefits and costs?
The following documents—called a Summary of Benefits and Coverage—provide summaries of what each plan covers and what it costs. For in-depth descriptions of benefits and coverage, see What are the benefits of each plan?
Summaries of Benefits and Coverage: non-Medicare
2018
2019
What are the monthly plan costs?
2019
Medicare
|
Members enrolled in Part A and Part B of Medicare: |
Kaiser Permanente NW Senior Advantage |
|---|---|
|
Subscriber only |
$169.80 |
|
Subscriber and spouse1 |
$874.482 |
|
Subscriber and spouse1 |
$333.63 |
|
Subscriber and child(ren) |
$698.312 |
|
Subscriber and child(ren) |
$333.63 |
| Subscriber, spouse,1 and child(ren) (1 Medicare eligible) |
$1,402.992 |
| Subscriber, spouse,1 and child(ren) (2 Medicare eligible) |
$862.142 |
| Subscriber, spouse,1 and child(ren) (3 Medicare eligible) |
$497.46 |
1or state-registered domestic partner
2If a Kaiser Permanente NW subscriber is enrolled in Medicare Part A and Part B and covers a family member not eligible for Medicare, the family member 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
Medicare
| Members enrolled in Part A and Part B of Medicare: | Kaiser Permanente NW Senior Advantage |
|---|---|
| Subscriber only | $173.07 |
| Subscriber and spouse1 (1 Medicare eligible) |
$860.712 |
| Subscriber and spouse1 (2 Medicare eligible) |
$341.12 |
| Subscriber and child(ren) (1 Medicare eligible) |
$688.802 |
| Subscriber and child(ren) (2 Medicare eligible) |
$341.12 |
| Full family (1 Medicare eligible) |
$1,376.442 |
| Full family (2 Medicare eligible) |
$856.852 |
| Full family (3 Medicare eligible) |
$509.17 |
1or state-registered domestic partner
2If a Kaiser Permanente NW subscriber is enrolled in Medicare Part A and Part B and covers a family member not eligible for Medicare, the family member 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.
2019
Non-Medicare
|
Plan |
Subscriber only |
Subscriber and spouse1 |
Subscriber and child(ren) |
Subscriber, spouse,1 and child(ren) |
|---|---|---|---|---|
|
Kaiser Permanente NW Classic |
$710.65 |
$1,415.33 |
$1,239.16 |
$1,945.84 |
|
Kaiser Permanente NW CDHP |
$604.16 |
$1,196.38 |
$1,062.91 |
$1,596.81 |
1 or state-registered domestic partner
2018
Non-Medicare
| Members not eligible for Medicare (or enrolled in Part A only) | Subscriber only | Subscriber and spouse1 | Subscriber and child(ren) | Subscriber, spouse,1 and child(ren) |
|---|---|---|---|---|
| Kaiser Permanente NW Classic | $692.66 | $1,380.30 | $1,208.39 | $1,896.03 |
| Kaiser Permanente NW CDHP | $590.87 | $1,170.25 | $1,039.99 | $1,561.04 |
1 or state-registered domestic partner
Do I live in the medical plan's service area?
In most cases, you must live in a medical plan’s service area to join the plan. Use the tables below to make sure you live in the plan's service area.
Washington
| Plan | County A-K | County L-S | County T-Z |
|---|---|---|---|
|
Kaiser Permanente NW Classic (These plans not available to Medicare members.) |
Clark Cowlitz |
None. | None. |
| Kaiser Permanente NW Senior Advantage |
Clark Cowlitz |
Lewis
Skamania |
Wahkiakum (ZIP Codes: 98612 and 98647) |
Oregon
| Plan | County A-K | County L-S | County T-Z |
|---|---|---|---|
|
Kaiser Permanente NW Classic |
Benton
Clackamas
Columbia Hood River (ZIP Code: 97014) |
Lane
Linn
Marion
Multnomah Polk |
Washington Yamhill |
| Kaiser Permanente NW Senior Advantage |
Benton (ZIP Codes: 97330, 97331, 97333, 97339, and 97370) Clackamas Columbia Hood River |
Linn (ZIP Codes: 97321-22, 97335, 97355, 97358, 97360, 97374, and 97389) Marion Multnomah Polk |
Washington Yamhill |
Contact
Kaiser Foundation Health Plan of the Northwest
Online: Kaiser Permanente NW for PEBB
Phone: 503-813-2000 or 1-800-813-2000
TTY: 711
