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 Group Health Cooperative's Medicare Advantage plan or Kaiser Permanente Senior Advantage must complete and sign the Medicare Advantage Plan Election Form (Form C) to enroll in one of these plans.

2017 Medical plan premiums

Members enrolled in Part A and Part B of Medicare: Group Health Medicare Plan Group Health Classic Group Health SoundChoice Group Health Value Kaiser Permanente Senior Advantage UMP Classic
Subscriber Only $176.17 N/A** N/A** N/A** $163.63 $278.13
Subscriber & Spouse*

(1 Medicare eligible)

N/A** $847.97 $747.25 $770.26 820.01*** 897.06

Subscriber & Spouse*
(2 Medicare eligible)

347.62 N/A** N/A** N/A** 322.54 551.54

Subscriber & Child(ren)
(1 Medicare eligible)

N/A** 680.02 604.48 621.74 655.92*** 742.33

Subscriber & Child(ren)
(2 Medicare eligible)

347.62 N/A** N/A** N/A** 322.54 551.54

Full Family
(1 Medicare eligible)

N/A** 1,351.82 1,175.56 1,215.83 1,312.30*** 1,361.26

Full Family
(2 Medicare eligible)

N/A** 851.47 775.93 793.19 814.83*** 1,015.74

Full Family
(3 Medicare eligible)

519.07 N/A** N/A** N/A** 481.45 824.95

* or state-registered domestic partner

** If a Group Health subscriber is enrolled in Medicare Part A and Part B but covers a family member who is not eligible for Medicare, the family member must enroll in a Group Health Classic or Value plan and the subscriber will pay a combined Medicare and non-Medicare rate.

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

Medicare Supplement Plan F premiums

Administered by Premera Blue Cross

  Plan F (age 65 or older, eligible by age) Plan F (Under age 65, eligible by disability)
Subscriber Only $109.59 $211.27
Subscriber & Spouse* (1 Medicare eligible)** 728.52 830.20
Subscriber & Spouse* (2 Medicare eligible - 1 retired, 1 disabled) 316.14 316.14
Subscriber & Spouse* (2 Medicare eligible) 214.46 417.82
Subscriber & Child(ren) (1 Medicare eligible)** 573.79 675.47
Full Family (1 Medicare eligible)** 1,192.72 1,294.40
Full Family (2 Medicare eligible - 1 retired, 1 disabled)** 781.84 781.84
Full Family (2 Medicare eligible)** 678.66 882.02

* 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)

  DeltaCare Uniform Dental Plan Willamette Dental Group
Subscriber Only $39.53 $45.07 $42.37
Subscriber & Spouse* 79.06 90.14 84.74
Subscriber & Child(ren) 79.06 90.14 84.74
Full Family 118.59 135.21 127.11

* 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 family member (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.