A Guide to Kaiser Permanente Medicare Advantage Plans in 2024
Kaiser Permanente Medicare Advantage plans are a great alternative to Original Medicare. Not only will they offer you all the coverage of Medicare Parts A and B, but they’ll also provide you coverage for additional services like dental, hearing health, and prescription medications.
FYI: To learn more about Medicare Advantage plans, read our rundown of this year’s best Medicare Advantage plans.
Kaiser Medicare Advantage Pros and Cons
Pros
- Predictable Pricing: Kaiser Permanente provides Medicare Advantage plans that have low costs and fixed copays, making it easier to plan any anticipated healthcare costs.
- Customer Satisfaction: Kaiser has high ratings regarding customer satisfaction. They excel in claims handling and customer service.
- All-in-one facilities: Kaiser's network includes doctors and facilities that Kaiser owns. They have facilities for you to receive all your healthcare needs under one roof.
Cons
- Networks: You can only see Kaiser healthcare providers with Kaiser plans. It provides a tiny provider network and means that, in most cases, you won't be able to keep your doctor if you enroll in Kaiser.
- Timely appointments: Because they have a small provider network, you can expect to schedule appointments a bit in advance.
Alternatives to Kaiser
No Medicare Advantage plan is right for every person. In addition to Kaiser, we also recommend checking out coverage options from our top-rated carriers.
Kaiser Medicare Advantage Costs
When it comes to Medicare Advantage plans important to understand that costs and benefits can vary. Where you live provides the greatest impact on plan costs and the benefits offered.
Kaiser HMO Pricing
| Location | Monthly Premium | Deductible | Maximum Annual Out of Pocket |
|---|---|---|---|
| California | $0.00 | $0.00 | $5,900 |
| Florida | $0.00 | $100.00 | $6,600 |
| New York | $19.00 | $0.00 | $6,700 |
| Texas | $0.00 | $0.00 | $5,600 |
Kaiser PPO Pricing
| Plan | Monthly Premium | Deductible | Maximum Annual Out of Pocket |
|---|---|---|---|
| California | n/a | n/a | n/a |
| Florida | n/a | n/a | n/a |
| New York | n/a | n/a | n/a |
| Texas | n/a | n/a | n/a |
Current Medicare Advantage Plans
Health Maintenance Organization
Kaiser only offers HMO plans. These medicare health plans only allow coverage from in-network providers unless it's an emergency.
With Kaiser, you'll have most of your appointments and treatment in one of their facilities. Your primary care doctor manages your healthcare and ensures you receive preventive care.
Special Needs Plans
Kaiser does offer Special Needs Plans that follow the HMO service areas. These plans cater to Medicare beneficiaries that have special needs. Such as chronic health conditions, Medicaid, or living in an institution.
These plans must include prescription drug plans that match the special need the plan is designed for.
When you enroll in a Medicare Advantage plan, you're typically locked in for the calendar year. You can only apply if you are in an enrollment period or a qualified situation.
In many areas where Kaiser is offered, they have 5-star plans. This allows you to enroll in one of their plans at any time of the year. These plans provide a limit on out-of-pocket costs.
Additional Benefits
Typically, Kaiser Medicare Advantage plans offer additional benefits for their plan members. These are benefits on top of the ones provided by Original Medicare.
Gym Membership
Kaiser Permanente offers its members a fitness program through Silver&Fit at no cost. This membership allows their policyholders to visit a gym to work out and take classes designed for Medicare beneficiaries. Staying active is an essential part of your physical wellness.
Dental Coverage
Kaiser offers dental coverage in many of its plans. You'll be required to pay an additional premium in some programs.
Vision Coverage
Routine eye care such as eye exams, eyewear, and contact lenses are typically a benefit available through a Kaiser Medicare Advantage plan.
Hearing Coverage
Kaiser Permanente Medicare Advantage plans will usually have some hearing coverage. Depending on your plan, you could receive hearing exams and hearing aids.
Over-The-Counter Allowance
These benefits allow you to purchase prescriptions and items that don't require a prescription. Some examples are Prilosec and Tylenol. Other things that can be bought include toothpaste, knee braces, and ice packs.
You can review your plan's evidence of coverage to see how each of these plan extras is included or covered.
Customer Service
Kaiser Permanente has a reputation for excellent customer service. You can get help from member services by calling the toll-free number on the back of your I.D. card, email, and online patient portal.
Kaiser Medicare Advantage Service Area
Kaiser is only available in select states and territories throughout the nation. These areas are very competitive and offer great benefits and services. They only offer HMO-style Medicare part C programs. Listed below are the states Kaiser Permanente offers Medicare Advantage plans.
- California
- Colorado
- Georgia
- Hawaii
- Maryland
- Oregon
- Virginia
- Washington State
- Washington D.C
Kaiser Financial Strength
Kaiser is a financially stable company offering insurance products for over 75 years. The National Committee for Quality Assurance rates Kaiser Permanentes plans at 4.5 to 5 -star ratings in most areas. AM Best does not offer a rating for Kaiser.
To learn more about our favorite Medicare insurance, check out our helpful guides:
Frequently Asked Questions
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Which Medicare Advantage plans does Kaiser offer?
Kaiser only offers Medicare Advantage plans with managed care networks. They provide coverage for Health Maintenance Organizations and Special Needs Plans that are also HMO based.
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How many states have Kaiser Medicare Advantage plans?
Kaiser only offers Medicare Advantage plans in select areas. The states included are Oregon, Washington, California, Georgia, Colorado, Hawaii, Maryland, Virginia, and Washington D.C.
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What does Kaiser Medicare Advantage cover?
Kaiser Permanente Medicare health plans provide a simple, all-in-one solution for your Medicare benefits. The coverage includes all benefits provided by Medicare Part A and Medicare Part B. In most cases, Medicare Part D prescription drug coverage is also included.
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Which is better: Kaiser Medigap or Medicare Advantage?
Kaiser Medicare Advantage plans will come with lower premiums; however, their Medigap plans will offer coverage for coinsurance, copays, and deductibles. While neither option is better, it will come down to personal preference.
