Kaiser Permanente Medicare Advantage Plans

Kaiser Permanente is one of many private insurance companies that sell Medicare Advantage plans (Medicare Part C).

Learn more about Medicare Advantage plans and get help comparing and shopping for plans that are available in your area.

What types of Medicare Advantage plans does Kaiser Permanente offer?

There are several different types of Medicare Advantage plans. Some of the primary types of Medicare Advantage plans include:

  • Health Maintenance Organization (HMO)
  • Preferred Provider Organization (PPO)
  • Private Fee-For-Service (PFFS)
  • Special Needs Plan (SNP)
  • Medicare Cost Plans

Health Maintenance Organization (HMO)

An HMO Medicare Advantage plan utilizes a primary care physician who coordinates your health care services and makes referrals to specialists for any further treatment you need.

You might not receive plan coverage if you seek care outside of the plan’s network, so it’s typically advised to visit only participating health care providers within your HMO plan network.

Kaiser Permanente sells HMO Medicare Advantage plans in California, Colorado, Georgia, Hawaii, Maryland, Oregon, Washington and Washington D.C.

Preferred Provider Organization (PPO)

A PPO Medicare Advantage plan generally does not require the use of a primary care physician. PPO plans also typically allow for some plan coverage to be utilized outside of the provider network, giving members a little more freedom to pick and choose their health care options.

If you receive care outside of your PPO plan network, you could potentially pay higher out-of-pocket costs than if you received in-network care.

Kaiser Permanente does not offer PPO Medicare Advantage plans.

Private Fee-For-Service (PFFS)

A Medicare Private Fee-For-Service plan consists of a list of health care providers who have agreed to the terms and payment conditions predetermined by the plan. These plans can provide increased cost certainty for members and the flexibility to visit a larger number of providers than with some other plans.

Kaiser Permanente does not offer PFFS Medicare Advantage plans.

Special Needs Plan (SNP)

A Special Needs Plan is a type of Medicare Advantage plan that is tailored to fit the needs of someone with a specific health condition or circumstance.

For example, an SNP may include a network of providers who specialize in treating a particular condition and may cover the prescription medications that are typically used to treat it. These plans provide an opportunity for people with specific health care needs to get the treatment they need.

*Kaiser Permanent sells SNP Medicare Advantage plans in California, Colorado, Georgia and Hawaii.  

Medicare Cost Plans

A Medicare Cost plan can allow beneficiaries to use their Medicare Advantage plan network of preferred providers for much of their health care needs while still retaining their Original Medicare coverage. If a beneficiary seeks medical care outside of their Medicare Advantage plan network, their Original Medicare benefits can help cover the costs.

*Kaiser Permanente sells Medicare Cost plans in Virginia and Maryland.   

What benefits can Medicare Advantage plans offer?

A Medicare Advantage plan is an alternative way to receive Medicare Part A and Part B coverage. The plans are required by law to offer all the same coverage found in Medicare Part A and Part B (Original Medicare), and some plans may offer additional Medicare-approved benefits.

Some of the additional benefits that may be commonly found in Medicare Advantage plans – such as Medicare Advantage plans sold by Kaiser Permanente – can include dental, vision, hearing and prescription drug coverage.

Many Medicare Advantage plans may even include perks such as memberships to gyms or wellness programs.

How do you enroll in a Medicare Advantage plan?

To enroll in a Medicare Advantage plan, you’ll need to be enrolled in both Medicare Part A and Part B. Then you’ll need to shop for available plans in your area.

While Original Medicare is provided by the federal government and is standard in every state, Medicare Advantage plans are sold by private insurance companies like Kaiser Permanente.

The availability, cost and coverage of Medicare Advantage plans will area to another. If you want to compare plans that are available where you live, you can call a licensed insurance agent who can review your options with you.

Call TTY Users: 711 24 hours a day, 7 days a week to learn more and to speak with a licensed agent.

Copyright 2018 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.