Kaiser’s Medicare Advantage Plans Review
Kaiser offers Medicare Advantage plans in only 8 states, but most of the plans offer $0 copays.
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Kaiser Permanente is a large consortium of medical services and facilities that primarily offers direct doctor-to-patient care, but it also offers private insurance in several locations across the country. It even offers Medicare Advantage (Part C) plans to people who qualify for Medicare. The plans are available in only eight states, but they have competitive pricing and benefits, including $0 copays for most of the plans.
It’s no wonder Kaiser Permanente made our list of the best Medicare Advantage plans for its high member satisfaction and ratings. That doesn’t mean it’s the best choice for everyone, though, especially considering its limited availability. You need to weigh the pros and cons, examine what’s included in the plans, and determine if it’s enough for your coverage needs. Our experts assessed Kaiser’s Medicare Advantage plans, and we laid out everything for you here.
Pro Tip: Looking for a carrier with more nationwide availability? Check out our top pick, Humana. Humana’s Medicare Advantage plans are available in all 50 states.
Pros About Kaiser Medicare Advantage
- No copays for preventive care: Regardless of the plan you choose, you will not pay copays for qualifying preventive care. That means if you need to go to the doctor for vaccines, blood tests, checkups or similar care, you may not have to pay anything. That could save you hundreds of dollars per year in out-of-pocket medical expenses.
- Emergency coverage abroad: One of Kaiser’s biggest advantages over other carriers is its coverage for those who travel abroad. With Kaiser, you can travel anywhere in the world with the peace of mind that you have emergency health coverage if you need it.
- Comprehensive telehealth care: Many seniors struggle with mobility issues, which can make even routine doctor’s visits a challenge. Kaiser offers various telehealth services so Part C enrollees can call or video chat with providers from the comfort of their own homes.
- Multifaceted Kaiser Permanente app: Kaiser has a mobile app to make communication and scheduling even easier. You can ask nonroutine medical questions and schedule appointments with your doctor. That way, you do not need to wait on hold to speak to a medical professional or representative at your local clinic. If you forget when you have an appointment or need to review medical information, you can open the app to view or change appointments, read test results, and look over notes from your doctor.
- Most plans have prescription drug (Medicare Part D) coverage: The majority of Kaiser Medicare Advantage plans come with prescription drug coverage. You also have the option to buy prescription drug plans separately from Kaiser.
Cons About Kaiser Medicare Advantage
- Some services limited to Kaiser facilities: Kaiser limits some of its Medicare Advantage services to treatments received at Kaiser Permanente medical facilities. If you want to schedule appointments through the Kaiser app, for example, the appointment will have to be at a Kaiser-affiliated clinic or hospital.
- Telehealth available at Kaiser’s discretion: Telehealth may not be available, depending on your location and other factors. It is difficult to know exactly how often patients can access it. Kaiser states that telehealth care can be used when “appropriate and available.”1 That means you may or may not be able to use telehealth regularly, even if you have a plan that offers it as a standard benefit.
- Mostly HMO plans: Many Medicare Advantage companies offer a wide range of plan types, including HMO, PPO and PFFS. Kaiser offers mainly HMO plans (or SNPs for those who qualify). Patients will have to get care within their local network to have their treatment covered, except in the event of a medical emergency.
- Limited availability: Many Medicare Advantage carriers have widespread availability across the country, but Kaiser Part C plans are available in only eight states and Washington, D.C.
Did You Know? You have multiple ways to learn more about Kaiser’s Medicare Advantage plans. One of those options is attending an in-person or online seminar with a Kaiser Medicare specialist.
Available Kaiser Medicare Advantage Plans
Kaiser is mostly limited to health maintenance organization (HMO) plans. Although you will have to get treatment within a network and choose a primary care physician, you can change your PCP at any time. You can also add riders to your plan via the Advantage Plus add-on, depending on your location. For a small monthly fee, Advantage Plus provides dental coverage and discounts on eyewear and hearing aids. Below, we’ll take a closer look at the primary Part C plan types Kaiser Permanente offers.
HMO
Kaiser HMO plans limit all nonemergency health coverage to a network of doctors, specialists and facilities. Most Kaiser HMO plans also include Part D prescription drug coverage. You can add Advantage Plus (as noted above) for even more coverage. Many of Kaiser’s HMO plans include worldwide emergency coverage, but they are still best for older adults and other Medicare beneficiaries who do not travel frequently because your standard coverage extends only to a specific network of health-care providers.
FYI: Enrolling in Medicare for the first time? Visit our guide to Medicare enrollment for everything you need to know.
HMO-POS
In addition to HMO plans, Kaiser offers health maintenance organization point-of-service (HMO-POS) plans, which give users limited out-of-network coverage. It will let you get nonemergency treatment outside your network, but such treatment will cost you more than in-network care. In most cases, however, the HMO-POS plan pays more toward out-of-network services if you obtain a referral from your in-network primary-care physician. Without a referral, out-of-network, nonemergency care can cost almost the same as going to the doctor with no insurance at all. Nonetheless, an HMO-POS plan can give you the flexibility to choose your healthcare provider while traveling while still enjoying HMO benefits.
PPO
Preferred provider organization (PPO) plans allow visits to any Medicare-accepting doctor without having to get prior authorizations for treatments or specialists. With access to a broader network than HMOs, out-of-network care costs more. Kaiser offers a few PPO plans. PPOs are best for older adults and other Medicare beneficiaries, as well as frequent travelers who want flexibility and fewer restrictions.
SNP
A special needs plan (SNP) is available to older adults and other Medicare beneficiaries who qualify based on specific diseases, health circumstances, financial situation or a combination of all three. Kaiser offers one kind of SNP (a dual-eligible SNP) that is specifically designed to meet the needs of those with unique health conditions and an income below a designated threshold.
SNPs and D-SNPs, however, are available only to a small number of applicants under special circumstances. If you want a Kaiser Part C plan, you will most likely have to choose an HMO plan.
Extra Perks and Benefits
Advantage Plus is one of the best ways to get extra benefits with your Kaiser Medicare Advantage plan. It provides varying degrees of dental, hearing and vision coverage in one insurance plan. Kaiser offers a few other extra perks and benefits worth noting:
- OTC benefit: With some Kaiser plans, you can get common over-the-counter products like vitamins and cold medicine at no extra cost. You simply need to place an order through Kaiser’s online catalog of products. Kaiser offers a quarterly allowance on OTC products that varies by plan.
- Fitness benefit: The Kaiser Silver&Fit Healthy Aging and Exercise Program includes access to free or discounted services at local gyms and some types of home exercise equipment.
- Home meal delivery: Certain plans allow enrollees to get meals delivered directly to their homes after a hospital visit involving serious medical conditions like heart failure. Though this applies in limited situations only, it is a great feature that is included at no extra cost.
- MinuteClinic: While traveling, members can visit approved MinuteClinics for urgent care needs.
Did You Know? Almost all Kaiser plans come with prescription drug coverage, which means that you won’t have to spend more on a stand-alone Part D plan.
Like most Medicare Advantage companies, Kaiser offers these benefits only with certain plans. You will need to review the plans available in your area to see which benefits they offer. You can either apply online through Kaiser’s website or reach out to a Kaiser agent by phone.
How Much Do Kaiser Medicare Advantage Plans Cost?
Medicare Advantage plan costs vary widely based on your location and health requirements, regardless of the insurance carrier you choose. Nearly half of all Kaiser plans have no monthly premium and offer $0 copays for most routine services. For those that do have a premium, the nationwide average is a little over $70 per month.2 That will inevitably vary, however, based on where you live and the details of your plan.
Whether or not your plan has a premium, you will still have to pay your Part B premium, which, as of 2025, averages about $185 per month. The following factors can also affect the overall cost of your insurance and health care:
- Deductible: The deductible is the amount you have to pay out of pocket before your Medicare Advantage plan starts splitting the cost with you (your insurance pays 80 percent for most types of care). Many Kaiser plans have no annual deductible, which means you will be covered as soon as your plan begins.
- Copay: Kaiser offers $0 copays on many routine treatments. For nonroutine treatments or doctor’s visits that otherwise do not qualify, you may pay roughly $20 per visit. Keep in mind that the amount can vary among doctors, specialists and facilities.
- Out-of-network costs: Since all Kaiser plans have networks, you will need to consider where you get your nonemergency treatment. In-network treatment is much cheaper, while out-of-network treatment can be far more expensive — even when it is partially covered by your Medicare Advantage plan.
- Advantage Plus: If you want extras such as dental, hearing and vision coverage, you may need to pay a small monthly fee for Kaiser’s Advantage Plus offering. Fortunately, it will not significantly raise your medical expenses, since you can get all three major benefits for as little as $17 per month.
Where Are Kaiser Medicare Advantage Plans Available?
Kaiser Permanente provides care to more than 1.9 million Medicare members in eight states — California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia and Washington State — and Washington, D.C., 3 Kaiser will likely expand its coverage area in the future, but the vast majority of American older adults cannot access Kaiser Part C at this time.
Did You Know? You can download Kaiser’s guide 7 Tips for Choosing a Medicare Health Plan to help you choose a plan that’s right for your needs.
Reviews and Ratings
Even if you live in a location that offers Kaiser Medicare Advantage plans, it’s important to do your research before purchasing a plan. Fortunately, various agencies specialize in analyzing the quality of Medicare Advantage carriers and their services. Here are a few of the most reputable reviews and ratings of Kaiser Permanente and its Part C offerings:
- Better Business Bureau (BBB): B
- National Committee for Quality Assurance (NCQA): 4.5 out of 5 stars
- Centers for Medicare and Medicaid Services (CMS): 5 out of 5 stars
Customer Service
If you already have a Kaiser Medicare Advantage plan, you can sign up to use the Kaiser mobile app with your Kaiser account. The application will allow you to ask questions and send messages directly to your local doctor’s office. For additional customer service, you can call a Kaiser Permanente Medicare specialist seven days a week between 8 a.m. and 8 p.m. If you are interested in acquiring a Part C plan with Kaiser, you can also search for a local agent on their website.
>> Related Reading: DevotedHealth Medicare Advantage Plans Review
Kaiser vs. the Competition
Several carriers offer Medicare Advantage plans, and they all offer good plan options. If you want to make sure you’re getting the best coverage, it helps to look at the competition.
Kaiser vs. UnitedHealthcare
UnitedHealthcare is the country’s largest Medicare Advantage, D-SNP and Medicare supplement carrier. It serves 1 in 5 Medicare beneficiaries, or over 13 million people.4 UnitedHealthcare has a variety of Medicare Advantage plans for members nationwide. Both Kaiser and UnitedHealthcare offer nice benefits, but UnitedHealthcare takes it a step further with benefits such as insulin copays for $25. Read our UnitedHealthcare review to learn more.
Kaiser vs. Aetna
Aetna Medicare Advantage works with CVS Health, so members get added benefits such as using walk-in MinuteClinics at CVS locations. They also get dental, vision and hearing coverage. Kaiser stands out for offering coverage abroad, but the carrier serves only eight states. Aetna covers all 50 states, with prescription drug plans available in 44 states. Most of Kaiser’s plans have prescription drug coverage.
Kaiser vs. Blue Cross Blue Shield
Blue Cross Blue Shield Medicare Advantage offers coverage in 49 states, as well as Washington, D.C., and Puerto Rico, while Kaiser covers only eight states. BCBS offers SilverSneakers, which is similar to Kaiser’s Silver&Fit Healthy Aging and Exercise Program. BCBS’s Blue365 discount program on some plans is similar to Kaiser’s OTC benefits. Both companies offer benefits, but BCBS has far more plan options.
Our Methodology
Our team of specialists spent more than 50 hours conducting a comprehensive review of Kaiser Medicare Advantage plans. We examined crucial aspects, including the insurer’s reliability, variety of plans, affordability of premiums and copays, and added benefits. Below is a detailed overview of the criteria we used in our evaluation.
- Plan selection and coverage: We evaluated a range of plans, including PPO, HMO, PFFS and SNP, analyzing their hospital and medical benefits, prescription drug coverage and additional benefits such as dental and fitness programs.
- Cost and value assessment: We examined the financial aspects of each plan, including monthly premiums, deductibles, copays and coinsurance. Our evaluation also considered out-of-pocket limits and potential costs for hospital stays and other essential health care needs to determine overall affordability.
- Customer satisfaction and support: We analyzed each plan using ratings such as NCQA and CMS, as well as customer experience and ratings. We also assessed communication channels and the efficiency of processing claims.
- Bonus benefits and perks: We considered the value of extra features such as meal delivery, transportation, walk-in clinic access and telehealth services, recognizing their importance to senior members.
Final Thoughts on Kaiser Medicare Advantage Plans
Kaiser offers high-quality Medicare Advantage plans. Even though you can get affordable and customizable care with Kaiser, the company’s Medicare Advantage plans are available only to a relatively small percentage of the population. Moreover, Kaiser offers only a few options beyond traditional HMO plans. Nonetheless, if you live within the provider’s network and are in the market for Medicare Advantage, you can get great service and relatively low out-of-pocket expenses with a Kaiser Permanente Medicare Advantage plan.
Frequently Asked Questions
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Is a Medicare Advantage plan from Kaiser a good choice?
Yes, most of the HMO plans offered by Kaiser Medicare Advantage have $0 monthly premiums and copays. Kaiser also offers some great perks, such as emergency health coverage when you travel.
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Do Medicare Advantage plans have hearing benefits?
Unlike Original Medicare, most Medicare Advantage plans usually include dental, hearing and vision care.
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Is Medicare Advantage different from Medicare Part D?
Yes, it is different. A lot of Medicare Advantage plans have prescription drug benefits included, but many offer the option of stand-alone Medicare Part D prescription drug plans that can be added to Original Medicare.
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Is an HMO or PPO Medicare Advantage Plan better?
Which plan to go with depends on your budget and preferences. HMO plans are more affordable, while PPO plans provide more flexibility.
Kaiser Permanente. (2025). Telehealth Is Easy — Here’s How It Works.
NCOA. (2024). What Are the Costs of Medicare Advantage?
Kaiser Permanente. (2024). 2025 Medicare Star Ratings.
UnitedHealthcare. (2024). UH 2025 Medicare Advantage Plans.