Kaiser Permanente Medicare Advantage Plans

Kaiser Permanente provides several types of Medicare Advantage plans (Medicare Part C) throughout a number of locations in the U.S.

Medicare Advantage plans provide all the same basic benefits as Original Medicare (Medicare Part A and Part B), and many Medicare Advantage plans may offer additional benefits not covered by Original Medicare.

The extra coverage offered by some Medicare Advantage plans may include benefits like prescription drug coverage, as well as dental, vision and hearing care.

Types of Kaiser Medicare Advantage plans

Medicare Advantage plans sold by private insurance companies like Kaiser Permanente. There are several different types of Medicare Advantage plans, and some of the types of Kaiser Medicare Advantage plans include:

  • Health Maintenance Organization (HMO)
    A Medicare HMO plan typically includes a network of health care providers that plan beneficiaries can visit for covered care and services. If you seek health care outside of the HMO plan network, your care might not be covered, and you will likely pay higher out-of-pocket costs.

    Some HMO plans require you to select a primary care physician (PCP). If you need specialized care, you may be required to obtain a referral from your PCP in order to see a specialist within your plan network.

  • Special Needs Plans (SNP)
    A Medicare Special Needs Plan is a type of Medicare Advantage plan that is customized to fit the unique health care needs of beneficiaries with a specific health condition or financial circumstance.

  • Medicare Cost Plans
    Medicare Cost Plans can allow beneficiaries to use the benefits of a Medicare Advantage plan while also having the freedom to visit health care providers outside of their plan network. If a Medicare Cost Plan beneficiary receives out-of-network care, their Original Medicare benefits can be used to help cover costs.

Medicare Cost Plans can cover some of the hospital benefits and medical benefits that are covered by Medicare Advantage plans while also covering certain Medicare deductibles, copayments and coinsurance.

Additional types of Medicare Advantage plans

Insurance companies like Kaiser Permanente may offer other types of Medicare Advantage plans, which can include:

  • Preferred Provider Organizations (PPO)
    Members of a Medicare PPO plan generally do not have to select a primary care physician and do not need referrals to schedule visits with specialists. PPO plans may offer some flexibility to receive care outside of the plan network of providers, though you will likely have to pay higher out-of-pocket costs than if you received care within the plan network.

  • Private Fee-For-Service (PFFS)
    A Medicare PFFS plan may not include a network of providers, but it will typically include a list of health care providers who have agreed to accept the plan’s terms and predetermined payment amounts for particular services or items.

Kaiser Medicare Advantage eligibility and enrollment

To be eligible for a Kaiser Medicare Advantage plan, you must first enroll in both Medicare Part A and Part B, and you need to live in an area that is serviced by the plan you want.

Medicare Advantage plan availability, benefits and cost can vary based on location, and not all plan types are available in all locations.

There are three times throughout the year that someone may be able to enroll in a Medicare Advantage plan from Kaiser or from any other Medicare Advantage plan provider:

Medicare Initial Enrollment Period

  • During your Initial Enrollment Period, which typically starts three months before your 65th birthday, includes your birth month and extends for another three months.

Medicare Open Enrollment Period

To learn more about Medicare Advantage plans offered by companies like Kaiser Permanente and to compare plans that are available where you live, speak with a licensed insurance agent today by calling TTY Users: 711 24 hours a day, 7 days a week.

Copyright 2019 TZ Insurance Solutions LLC. All rights reserved.

MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts; enrollment in any plan depends upon contract renewal.

Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

Medicare has neither reviewed nor endorsed this information.