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What Do Kaiser Medicare Advantage Plans Offer?

By John McGuire
When you shop for Medicare Advantage plans, you may want to consider Kaiser's offerings. Here are some of the distinctive features of these plans.

Medicare Advantage plans help with savings by using networks of healthcare resources. By doing so, these plans cover many of the out-of-pocket expenses not covered by Original Medicare. Many Medicare Advantage plans also offer benefits that go far beyond what you get with Original Medicare, and Kaiser Permanente's Medicare Advantage plans are one such example. Here’s what these plans have to offer, according to Kaiser Permanente’s official website.

Medical Benefits Under Kaiser Medicare Advantage Plans

Before we begin, it’s important to know that Kaiser Permanente is not available in all states. Even in the states where Kaiser operates, Medicare Advantage plans may not be available in your zip code, so investigate this upfront. Plan benefits may also vary by your location. Here are the states in which Kaiser offers Medicare Advantage plans:

  • California
  • Colorado
  • Georgia
  • Hawaii
  • Maryland
  • Oregon
  • Virginia
  • Washington
  • Washington D.C.

There are several different types of Medicare Advantage plans, and the model of care offered by Kaiser is a Health Maintenance Organization (HMO) style plan. With HMO plans, you will typically need to choose a primary care provider withiin the organization. You will need authorizations from your primary care provider in order to see specialists or to get certain tests, according to the official U.S. government website for Medicare.

One of the benefits of Kaiser’s HMO-style Medicare Advantage plans is that they bring all the medical services you might need into one simple plan. With Original Medicare, there is separate coverage for hospital care (Part A), medical services (Part B), and drug coverage (Part D). With Kaiser Medicare Advantage, you’ll get comprehensive healthcare coverage bundled into one unified plan.

Another benefit of Kaiser Medicare Advantage is the cost savings. An annual deductible is the amount of money you must pay out-of-pocket before insurance starts to pay your medical bills. With Kaiser Medicare Advantage plans, the annual deductible for outpatient services is zero for most plans.

Finally, there is the issue of premiums—the periodic payment that you pay for medical coverage. With Kaiser Medicare Advantage plans, you can choose the level of your monthly premium to control things like your annual out-of-pocket expense limits or your co-payments for various services. 

In general, the more you are willing to pay in monthly premiums, the lower your fixed expense limits and co-payments for services will be. However, Kaiser also offers value plans that have a $0 monthly premium. In contrast, Original Medicare does not offer a fixed annual limit on your out-of-pocket expenses.

Non-Medical Benefits Under Kaiser Medicare Advantage Plans

When you are part of a Kaiser Medicare Advantage plan, you are eligible to join a Medicare Advantage Plus plan. This plan is offered for a low additional monthly premium and helps pay for several non-medical benefits, including:

  • Dental Benefits
  • Hearing Aid Benefits
  • Eyewear Benefits

In some locations, additional benefits are available through Medicare Advantage Plus plans, such as transportation, acupuncture, and other health and wellness programs.

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Interested in learning more about Medicare, Medigap, and Medicare Advantage plans? WebMD Connect to Care Advisors may be able to help.