Comprehensive Medicare Advantage Coverage for Seniors in Certain States
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Kaiser Permanente is a large consortium of medical services and facilities. While many of Kaiser's services include direct doctor-to-patient care, they also offer private insurance to consumers in several locations across the country. For people who qualify for Medicare, Kaiser has a few Medicare Advantage (Part C) plans available with competitive pricing and benefits. In this review, we will examine Kaiser's Medicare Advantage plans and evaluate their pros and cons.
Kaiser is mostly limited to health maintenance organization (HMO) plans. While 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. 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 two primary Part C plan types Kaiser Permanente offers.
Kaiser HMO plans limit all non-emergency health coverage to a network of doctors, specialists, and facilities. In-network care is far cheaper, while out-of-network, non-emergency care costs the same as going to the doctor with no insurance at all. Virtually all Kaiser HMO plans include Part D prescription drug coverage. You can add Advantage Plus (as noted above) for even more coverage. While many of Kaiser's HMO plans include worldwide emergency coverage, they are still best for older adults who do not travel frequently, as your standard coverage extends to a specific network of healthcare providers only.
FYI: Enrolling in Medicare for the first time? Visit our guide to Medicare enrollment for everything you need to know.
A special needs plan (SNP) is available to older adults 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 seniors with unique health conditions and an income below a designated threshold.
Pro Tip: SNPs and D-SNPs are available only to a small number of applicants, so if you want a Kaiser Part C plan, you will most likely have to choose an HMO plan.
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:
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 providers, 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.
Medicare Advantage plan costs vary widely based on your location and health requirements, regardless of the insurance provider you choose. Many 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. However, this will inevitably vary based on where you live and the details of your plan.
Did You Know? Kaiser prides itself on offering plans with low or no annual deductibles, which could save you thousands of dollars per year on medical expenses!
Whether or not your plan has a premium, you will still have to pay your Part B premium, which (as of 2022) averages about $170.10 per month. The following factors can also affect the overall cost of your insurance and healthcare:
As of 2022, you can get Kaiser Permanente Part C coverage only if you live in one of the following locations: California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, Washington state, or the District of Columbia. While Kaiser will likely expand its coverage area in the future, the vast majority of American older adults cannot access Kaiser Part C at this time.
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 providers and their services. Here are a few of the most reputable reviews and ratings of Kaiser Permanente and its Part C offerings:
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 the hours of 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.
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 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.
Kaiser Permanente. (2022). Why choose Medicare Advantage.