The PEBB Program’s annual open enrollment is November 1 through 30. Learn more.

Kaiser Permanente NW plans

Kaiser Foundation Health Plan of the Northwest offers plans in Clark and Cowlitz counties in Washington and select counties in Oregon.

Please note—this webpage uses tables: To see all columns in a table, especially on mobile, you may need to scroll or swipe left and right.

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:

Do you need help completing the Retiree Coverage Election form (form A)? Use the tutorial.

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

2020

2019

Certificates of Coverage: Medicare

2020

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

2020

2019

What are the monthly plan costs?

Medicare

Note: Medicare rates shown below have been reduced by the state-funded contribution up to the lesser of $183 or 50 percent of plan premium per retiree per month.

Members enrolled in Medicare Part A and Part B:

Kaiser Permanente NW Senior Advantage

Subscriber only

$173.91

Subscriber and spouse1
(1 Medicare eligible)

$884.512

Subscriber and spouse1
(2 Medicare eligible)

$342.75

Subscriber and child(ren)
(1 Medicare eligible)

$706.862

Subscriber and child(ren)
(2 Medicare eligible)

$342.75

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

$1,417.452

Subscriber, spouse,1 and child(ren)
(2 Medicare eligible)

$875.702

Subscriber, spouse,1 and child(ren)
(3 Medicare eligible)

$511.60

Note: Medicare rates shown below have been reduced by the state-funded contribution up to the lesser of $168 or 50 percent of plan premium per retiree per month.

Members enrolled in Medicare Part A and Part B:

Kaiser Permanente NW Senior Advantage

Subscriber only

$169.80

Subscriber and spouse1
(1 Medicare eligible)

$874.482

Subscriber and spouse1
(2 Medicare eligible)

$333.63

Subscriber and child(ren)
(1 Medicare eligible)

$698.312

Subscriber and child(ren)
(2 Medicare eligible)

$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. 

Non-Medicare

Members not eligible for Medicare
(or enrolled in Part A only)

Subscriber

Subscriber and spouse1

Subscriber and child(ren)

Subscriber, spouse1, and child(ren)

Kaiser Permanente NW1 Classic

$715.66

$1,426.25

$1,248.60

$1,959.20

Kaiser Permanente NW1 CDHP

$608.85

$1,206.99

$1,072.04

$1,611.85

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

$1,943.84

Kaiser Permanente NW CDHP

$604.16

$1,196.38

$1,062.91

$1,596.81

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

Members not eligible for Medicare
(or enrolled in Part A only)		 County A-K County L-S County T-Z

Kaiser Permanente NW Classic
Kaiser Permanente  NW CDHP

(These plans not available to Medicare members.)

Clark

Cowlitz

 None. None.
Kaiser Permanente NW
Senior Advantage

Clark

Cowlitz

Skamania

 Wahkiakum (ZIP Codes: 98612 and 98647)

Oregon 

Plan County A-K County L-S County T-Z

Kaiser Permanente NW Classic
Kaiser Permanente NW CDHP
These plans not available to Medicare members.

Benton (ZIP Codes: 97330, 97331, 97333, 97339, 97370, and 97456)

Clackamas

  • 2019 ZIP Codes: 97004, 97009, 97011, 97013, 97015, 97017, 97022, 97023, 97027, 97034, 97035, 97036, 97038, 97042, 97045, 97049, 97055, 97067, 97068, 97070, 97086, 97089, 97222, 97267, 97268, and 97269 (97028 not covered)
  • 2020 all ZIP Codes

Columbia

Hood River (ZIP Code: 97014)

Lane (ZIP Codes: 97401, 97402, 97403, 97404, 97405, 97408, 97409, 97419, 97424, 97426, 97431, 97437, 97438, 97440, 97448, 97451, 97452, 97454, 97455, 97461, 97475, 97477, 97478, 97487, and 97489)

Linn

  • 2019 all ZIP Codes
  • 2020 ZIP Codes: 97321, 97322, 97335, 97348, 97355, 97358, 97360, 97374, 97377, 97389, and 97446

Marion

  • 2019 ZIP Codes: 97002, 97020, 97026, 97032, 97071, 97137, 97301, 97302, 97303,  97305, 97306, 97307,  97308, 97309, 97310, 97311, 97312, 97313, 97314, 97317, 97325, 97342, 97346, 97352, 97362, 97373, 97375, 97381, 97383, 97384, 97385, 97392 (97350 not covered)
  • 2020 all ZIP Codes

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

Forms and publications

PDF icon PEBB retiree monthly premiums 2020
PDF icon Kaiser Permanente NW Senior Advantage Certificate of Coverage (COC) 2020
PDF icon Kaiser Permanente NW Consumer-Directed Health Plan (CDHP) (PEBB) Certificate of Coverage (COC) 2020
PDF icon Kaiser Permanente NW Classic (PEBB) Certificate of Coverage (COC) 2020

Related links

Visit the Kaiser Permanente NW website
Change your coverage
Compare medical plans
Medical benefits comparison tool
Medicare and PEBB benefits