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Medicare medical plan premiums Special requirements for Medicare premiums • At least one member on your account must be enrolled in Medicare Part A and Part B. • UnitedHealthcare plans are Medicare Advantage Part D (MAPD) plans. If a UnitedHealthcare Medicare plan is selected, non- Medicare eligible members are enrolled in UMP Classic. The rates re昀氀ect the total due, including premiums for both plans. For more information on this requirement, contact your medical plan’s customer service department. Note: These Medicare premiums do not include your Medicare Part B premium. * If a Kaiser Permanente Washington member is enrolled in Medicare Part A and Part B, and other enrolled members are not eligiblefor Medicare, the non-Medicare members must enroll in Kaiser Permanente Washington Classic, SoundChoice, or Value plan. Thesubscriber will pay a combined Medicare and non-Medicare premium. # If a Kaiser Permanente Washington member is enrolled in Medicare Part A and Part B, and other enrolled members are not eligible for Medicare, the non-Medicare members must enroll in Kaiser Permanente Washington Classic, SoundChoice, or Value plan. The subscriber will pay a combined Medicare and non-Medicare premium 3

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