Parent Medical Coverage

10/19/21, 2:22 PM Parent Medical Coverage
Parent Medical Coverage

Parent Medical Coverage (PMC) is group medical coverage offered by Kaiser Permanente for your Medicare-eligible parents.
PMC provides office visits and prescription drug coverage as well as preventive care, hospital and surgical care, mental health
care, and many other services. No medical review is required. Dental coverage is not included.
Topics you will find on this page

• Eligibility requirements

• How it works

• Benefit summary

• Your parents' costs

• When to enroll

• How to enroll

• When coverage begins

• When coverage ends

• Contact
More...
Eligibility requirements
https://hrconnect.kp.org/wps/myportal/hr/benefitsandwellness/benefitsandcoverage/myhealthbenefits/peoplefluentlinks/parentmedicalcoverage/!ut/p/z1/hZBNj4IwEIZ_iweP3RkQlB5Zo0FcQ9aPZdsLqVig… 1/9
To qualify for coverage, you and your parents need to meet the following eligibility requirements. Medicare
Coverage will be denied if all requirements are not met.
Employee Eligibility Parent Eligibility
You must be: Your parents must be:

an active employee regularly be enrolled in Medicare Parts A and B
scheduled to work 20 or more hours live in a Kaiser Permanente Medicare service area
per week assign their Medicare benefits to Kaiser Permanente
eligible for, but not necessarily reside in the same Kaiser Permanente region in which
enrolled in, a Kaiser Foundation Health you are enrolled
Plan (KFHP) or Kaiser Employee meet eligibility requirements for your region's Kaiser
Medical Health Plan Exclusive Provider Permanente Medicare-coordinated plan - Kaiser
Permanente Senior Advantage (KPSA) or Kaiser

Permanente Medicare Advantage, as applicable
Eligible parents are defined as:

your and your spouse's or domestic partner/civil union partner's natural parents
your and your spouse's or domestic partner/civil union partner's stepparents, if still married to or
widowed from your natural parents (a widowed stepparent who remarries will not be eligible for
coverage)
your and your spouse's or domestic partner/civil union partner's parent's domestic or civil union
partner | Domestic Partner Requirements | Civil Union Requirements
Dependents of parents are not eligible for this coverage.
More...
How it works
Your Medicare-eligible parents, stepparents, parents-in-law, and the parents or stepparents of your Medicare Star Ratings
domestic or civil union partner may have an opportunity to enroll in Kaiser Permanente medical coverage
at their own expense.
If your parents decide to enroll in Parent Medical Coverage (PMC), they will be responsible for paying the
full premium for the plan, plus a monthly administration fee per account. Your enrolled parents will be
notified in advance of any change in premiums.
WageWorks, the third-party administrator of this plan, will bill your parents directly for their coverage on
a monthly basis.
More...
Benefit summary
PMC is a comprehensive group plan. Some of the covered benefits include, but are not limited to:
Summary of Benefits
Plan feature Coverage amount
Allergy testing and Plan pays 100% after you pay a $5 copayment
treatment
Emergency room Plan pays 100% after you pay a $25 copayment
Hearing and vision Plan pays 100% after you pay a $5 copayment
exams
Office visits Plan pays 100% after you pay a $5 copayment
Optical allowance Plan provides an allowance of $150
Prescription drugs Plan pays 100% after you pay a $5 copayment for a 100-day supply, retail
or mail order
Dental coverage Not covered
For more information, review the Summary of Benefits.
Kaiser Permanente Medicare Senior Advantage (HMO) Individual Plans
There is a difference in the benefit level between the Kaiser Permanente Medicare Senior Advantage
(HMO) Individual plans and the Parent Medical Coverage.
To learn more about the Kaiser Permanente Individual Medicare health plans and services, visit KP.org.
Select "Shop Health Plans" at the top of the page.
More...
Your parents' costs
Your parents will be responsible for the entire amount of the premium for their coverage and the monthly Parent medical
administrative fee, as well as any applicable copayments (all subject to change annually).
coverage rates
Review the Parent Medical Coverage rates before enrolling.
More...
When to enroll
Before beginning the enrollment process, review the: Medicare
Parent Medical Coverage rates – outlines premiums for coverage (your parents will be responsible for
Change relationship
the entire amount of the premium for their coverage, administrative fee, as well as any applicable
status
copayments).
Summary of Benefits – lists the covered services and applicable co-payments When You Can Make
Medicare Star Ratings –compare the Parent Medical Coverage plan's performance to other plans. Changes
Your eligible parent(s) may elect coverage during open enrollment or during the following designated
enrollment periods:
Within your first 31 days of employment if you are newly hired or newly eligible for health plan
coverage
During open enrollment
Within 31 days of your own qualifying family or employment status change
Within 31 days of when your parent(s):
move into the Kaiser Permanente region by which you are employed
move into a Kaiser Permanente Medicare service area
become eligible for and enroll in Medicare Parts A and B
have a qualifying family status change
For all other status changes, contact the National Human Resources Service Center (NHRSC).
More...
How to enroll
During the designated enrollment period or within 31 days of experiencing a qualified event, sign on to HR Change relationship
Connect and access the Benefit Enrollment page.
status
When You Can Make

The Parent Medical Coverage enrollment information is at the end of your benefits election. Once you
Changes
review your initial eligibility, additional information will be email to you.
Enrollment Process
Step 1 Once you receive the email, complete pages 1 and 2 of the Parent Medical
Coverage Enrollment Application (4130) for each parent; both you and your
parent must complete and sign this form
Complete and notarize Kaiser Permanente Affidavit of Domestic Partnership
(#3190) if your or your spouse's parent's domestic partner is applying for
coverage
Step 2 Complete the Group Plan Enrollment Form for each parent
Step 3 Make copies of all the forms for your records

Mail or fax the following completed forms for each enrolling parent to the
National Human Resources Service Center (NHRSC) within 31 days of the date
you and your parent(s) become eligible, or within the specified annual open
enrollment period:
Election Request Form
Parent Medical Coverage Enrollment Application (4130)
Notarized Kaiser Permanente Affidavit of Domestic Partnership Form (if
applicable)
Copy of a certified domestic partner registration filed with a state or local
agency or civil union certificate (for your or your spouse’s parent’s domestic
partner/civil union partner, if applicable)
Be sure to include your 8-digit employee ID on the top of each form
More...
When coverage begins
Coverage will begin:
Enrollment Period Effective Date
When newly hired or newly eligible for health plan First of the month following the date
coverage requirements are met
During open enrollment January 1 of the following year
Due to your own qualifying family or employment First of the month following the date
status change requirements are met
Due to your parent's qualifying family status First of the month following the date
change requirements are met
Coverage will begin on the effective date listed above provided:

your completed and signed election forms are received by the NHRSC
your parent's eligibility for and enrollment in Medicare and Kaiser Permanente Senior Advantage has
been confirmed
premiums for medical coverage are paid
More...
When coverage ends
Your eligible parents will lose coverage when one of the following occurs: When You Can Make
You terminate employment Changes
You no longer meet the eligibility requirements
Parent Coverage
Your parents no longer meet the eligibility requirements
Disenrollment - 3450
Premiums for medical coverage are not paid
Change relationship
Parents may dis-enroll from Parent Medical Coverage (PMC) for any reason during the year.
status
Once your parents are dis-enrolled from PMC, their coverage will end on the last day of the calendar
quarter in which your status change occurs. They will be offered conversion to an individual plan, as
applicable. Coverage is not available through COBRA.
If your parents are enrolled in PMC when you retire, they may continue their coverage. However, once your
parents dis-enroll for any reason, their PMC coverage will cease, and they will not be eligible to re-enroll
during your retirement. PMC coverage is not available to new enrollments in retirement.
For details, contact the National Human Resources Service Center (NHRSC) or your regional HR/benefits
representative, as applicable.
More...
Contact
For more information about how Parent Medical Coverage works, contact:
National Human Resources Service Center (NHRSC)
Phone: 877-457-4772 (877-4KP-HRSC)
Fax: 877-477-2329 (877-HRSC-FAX)
WageWorks is the third-party administrator for PMC. Once enrolled, your parents can obtain information
about premiums and payments at 1-877-442-6204, Monday through Friday from 5 a.m. to 5 p.m. Pacific
time.
Content last audited: September 18, 2018
Need help? Get answers to common questions and more

Parent Medical Coverage

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10/19/21, 2:22 PM Parent Medical Coverage

Parent Medical Coverage

Topics you will find on this page

Employee Eligibility Parent Eligibility

You must be: Your parents must be:

Eligible parents are defined as:

Dependents of parents are not eligible for this coverage.

Plan feature Coverage amount

Office visits Plan pays 100% after you pay a $5 copayment

Optical allowance Plan provides an allowance of $150

Dental coverage Not covered

For more information, review the Summary of Benefits.

Kaiser Permanente Medicare Senior Advantage (HMO) Individual Plans

Review the Parent Medical Coverage rates before enrolling.

When You Can Make

review your initial eligibility, additional information will be email to you.

Step 3 Make copies of all the forms for your records

Be sure to include your 8-digit employee ID on the top of each form

Coverage will begin:

Enrollment Period Effective Date

During open enrollment January 1 of the following year

Coverage will begin on the effective date listed above provided:

National Human Resources Service Center (NHRSC)

Phone: 877-457-4772 (877-4KP-HRSC)

Fax: 877-477-2329 (877-HRSC-FAX)

Content last audited: September 18, 2018

Need help? Get answers to common questions and more

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