Medicare plan premiums
Find out the monthly cost of your Medicare plan.
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
To qualify for the Medicare rate:
- At least one covered family member must be enrolled in both Medicare Part A and Part B.
- 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.
If you cannot see the entire table, you may need to scroll or swipe left and right, or download a printable version.
Administered by Premera Blue Cross
- Make sure you live in the plan's service area.
- Contact the plan or check the plan's provider directory to make sure your providers are in the plan's network.
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.