2019 PEBB open enrollment has begun. You have until November 30, 2018 to make changes to your coverage.

Medicare plan premiums

Find out the monthly cost of your Medicare plan.

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.
  2. Medicare-enrolled subscribers in Kaiser Permanente WA Medicare Advantage plan or Kaiser Permanente NW Senior 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

$169.80

$167.91

N/A

N/A

N/A

$313.09

Subscriber and spouse1
(1 Medicare eligible)

$874.483

N/A2

$895.33

$765.15

$818.19

$981.96

Subscriber and spouse1
(2 Medicare eligible)

$333.63

$329.85

N/A

N/A

N/A

$620.20

Subscriber & Child(ren)
(1 Medicare eligible)

$698.313

N/A2

$713.47

$615.84

$655.62

$814.74

Subscriber & Child(ren)
(2 Medicare eligible)

$333.63

$329.85

N/A2

N/A2

N/A2

$620.20

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

$1,402.993

N/A2

$1,440.89

$1,213.07

$1,305.90

$1,483.62

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

$862.143

N/A2

$875.41

$777.78

$817.56

$1,121.86

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

$497.46

$491.79

N/A2

N/A2

N/A2

$927.32

1 or state-registered domestic partner

2 If a Kaiser Permanente WA subscriber is enrolled in Medicare Part A and Part B but covers a dependent who is not eligible for Medicare, the family member 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 but covers a dependent 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

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 $173.07 $175.40 N/A N/A N/A $333.64
Subscriber & Spouse1

(1 Medicare eligible)

$860.713 N/A2 $888.77 $777.49 $803.90 $986.48

Subscriber & Spouse1
(2 Medicare eligible)

$341.12 $345.78 N/A N/A2 N/A $662.26

Subscriber & Child(ren)
(1 Medicare eligible)

$688.803 N/A2 $710.43 $626.97 $646.78 $823.27

Subscriber & Child(ren)
(2 Medicare eligible)

$341.12 $345.78 N/A2 N/A2 N/A2 $662.26

Full family
(1 Medicare eligible)

$1,376.443 N/A2 $1,423.80 $1,229.06 $1,275.28 $1,476.11

Full family
(2 Medicare eligible)

$856.853 N/A2 $880.81 $797.35 $817.16 $1,151.89

Full family
(3 Medicare eligible)

$509.17 $516.16 N/A2 N/A2 N/A2 $990.88

1 or state-registered domestic partner

2 If a Kaiser Permanente WA subscriber is enrolled in Medicare Part A and Part B but covers a dependent who is not eligible for Medicare, the family member 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 but covers a dependent 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.

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

$112.16

$199.00

Subscriber and spouse* (1 Medicare eligible)3

$781.04

$867.88

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

$305.19

$305.19

Subscriber and spouse* (2 Medicare eligible) $218.35 $392.03

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

$613.82

$700.66

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

$1,282.69

$1,369.53

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

$807.60

$807.60

Subscriber, spouse,1 and child(ren) - (2 Medicare eligible)** $720.01 $893.69

* 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 $111.21 $216.05
Subscriber and spouse* (1 Medicare eligible)** $764.05 $868.89
Subscriber and spouse* (2 Medicare eligible - 1 retired, 1 disabled) $322.24 $322.24
Subscriber and spouse* (2 Medicare eligible) $217.40 $427.08
Subscriber and child(ren) (1 Medicare eligible)** $600.84 $705.68
Full family (1 Medicare eligible)** $1,253.68 $1,358.52
Full family (2 Medicare eligible - 1 retired, 1 disabled)** $813.37 $813.37
Full family (2 Medicare eligible)** $707.03 $916.71

* 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.

Note: Medicare rates shown above have been reduced by the state-funded contribution up to the lesser of $150 or 50 percent of plan premium per retiree per month.

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, spouse,1 and child(ren) $118.59 $137.61 $133.35

* or state-registered domestic partner

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

For more details, visit Surcharges.