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Kaiser Medicare Plans

Founded in 1945, Kaiser Permanente is one of the nation's largest not-for-profit health plans, with more than 8. 6 million members. They not only provide health coverage, but also the health care as well. By offering health coverage and medical care together, Kaiser Permanente boasts a coordinated circle of care that includes doctors, nurses, pharmacists, and X-ray and lab technicians that work together. All of Kaiser Permanente's plans are either HMOs or cost plans.

While their plans are geographically concentrated, Kaiser Permanente is still the fourth largest Medicare Advantage plan provider in the nation by enrollment.

Since members must use Kaiser Facilities, their plans are offered in limited areas, where a Kaiser facility exists. These areas include:

  • California
  • Colorado
  • Georgia
  • Hawaii
  • Northwest Kaiser Permanente service areas
  • Mid Atlantic (East Coast) Region
  • Ohio

Plan Benefits

The Kaiser Permanente plan provides medical care, health coverage and prescription drug coverage to their members at their facilities, so obviously choices in providers are quite limited. On the other hand, Kaiser Health facilities may provide a continuum of care that benefits senior citizens. Kaiser Permanente plan benefits include:

  • Primary care, X-ray services, lab testing and pharmacy services in one location
  • Weekend, after hours and same day appointments
  • Dental and hearing coverage is available
  • An online health tracking system
  • Health and wellness tools

Plan Details

Kaiser Permanente Medicare plans offer more benefits than traditional Medicare, including Part D* prescription drug coverage, plus built-in wellness programs that promote total health for seniors.

Members pay monthly premiums and copayments for the services from Kaiser Permanente, in addition to the standard monthly Medicare premiums. Premiums will vary depending on location, and in many areas, there are $0 premium options. Plan benefits include:

  • A $3,400 in network plan cost cap;
  • Doctors and providers must be part of a Kaiser Permanente facility.
  • Inpatient Hospital Care:There is no limit to the number of days covered by the plan each benefit period.
  • Psychiatric hospital stays (limited to 190 lifetime days)
  • There is $500 co-pay for inpatient hospital stays, compared to $110-$275 daily co-pay for traditional Medicare benefits.

Plan Costs

Plan costs provided are based on the options for Kaiser Permanente Plans in the Mid-Atlantic Region. Plan costs and details may differ in other areas of the country.

  • Premium:$0 - $96 monthly in addition to the traditional Medicare monthly benefit costs.
  • Total estimated annual costs are $3,900 for these policies, compared to $3,150 for traditional Medicare plans.
  • Costs of services are based on co-payments ranging from $10 - $500 (hospital stays) versus the 20% cost of services provided by traditional Medicare.
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* You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for getting extra help, call:

1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call 1-877-486-2048, 24 hours a day/7 days a week;

The Social Security Administration at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY/TDD users should call, 1-800-325-0778; or Your State Medicaid Office

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