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Kaiser Permanente Medicare Advantage Reviews

Kaiser Permanente is a leading healthcare provider offering a variety of well-rated Medicare Advantage plans in several states, focusing on integrated care and preventive services.
By . Last update: June 11, 2024

Many of the plans featured here are available through our partners who may compensate us for enrollments. This influences which Medicare plans we write about, but it does not influence our evaluations. Our opinions are our own. Member opinions and comments are their own and do not express the views of MedicareWire. How we make money.

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  • Our approach: We analyze government data, study consumer intelligence websites, and scour the web for consumer sentiment.
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Kaiser Medicare Advantage Reviews
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Kaiser Permanente (Kaiser) offers a range of Medicare Advantage (Part C) plans that emphasize integrated care and preventive services, aiming to enhance members’ overall health and well-being. Known for its coordinated care approach, Kaiser’s plans often include additional benefits such as vision, dental, and wellness programs to support a healthier lifestyle.[1]

In this editorial review, we will explore some of Kaiser Permanente’s top Medicare Advantage plans, focusing on their coverage options, costs, network of healthcare providers, and feedback from members about their experiences.

Table of Contents

Member Reviews for Kaiser

The following Kaiser reviews have been left by our members.

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PROS

  • Integrated Care Model: Kaiser Permanente is known for its integrated care approach, combining healthcare services and insurance coverage, which can lead to more coordinated and efficient care.
  • High Member Satisfaction: Kaiser Permanente often receives high ratings for member satisfaction, reflecting positive experiences with customer service and healthcare quality.
  • Preventive Services: Many plans include extensive preventive services, such as routine check-ups, screenings, and wellness programs, to support proactive health management.
  • Additional Benefits: Plans frequently offer extra benefits not covered by Original Medicare, including dental, vision, hearing, and fitness programs.
  • Technology and Telehealth: Kaiser Permanente provides robust telehealth services, making it easier for members to access care remotely.

CONS

  • Limited Geographic Availability: Kaiser Permanente Medicare Advantage plans are not available nationwide, which limits options for beneficiaries outside their service areas.
  • Network Restrictions: Members must typically use Kaiser Permanente's network of providers, which can limit choice and flexibility compared to plans with broader networks.
  • Prior Authorization Requirements: Some services and treatments may require prior authorization, potentially delaying care.
  • Annual Plan Changes: Like all Medicare Advantage plans, Kaiser Permanente's offerings, including benefits, premiums, and provider networks, can change annually.
  • Higher Premiums: In some areas, Kaiser Permanente plans may have higher premiums compared to other Medicare Advantage plans.
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How Do Kaiser Medicare Advantage Plans Work?

Kaiser Medicare Advantage plan members have all their hospital (Medicare Part A) and medical (Medicare Part B) benefits included in their plan. This includes everything from preventive care and vaccinations to visits with doctors and specialists, as well as hospital stays, skilled nursing services, and hospice care.

All Kaiser Medicare Advantage plans include coverage for:

  • Inpatient hospital admissions.
  • Doctor and specialist care.
  • Preventive care, screenings, and vaccinations.
  • Diagnostic services, lab work, X-rays and other imaging.
  • Outpatient services.
  • Ambulance transportation for emergencies.
  • Durable medical supplies and equipment.

Medicare regulations require that all private health plans offer at least the same coverage and benefits as Original Medicare. However, Kaiser sets its own out-of-pocket costs.

Some Kaiser plans include extra benefits such as routine dental, vision, hearing, and wellness programs. These services aren't typically covered by Original Medicare.

By signing up for a Kaiser Medicare Advantage plan, many beneficiaries find it convenient to have all their healthcare services in one plan, which often includes lower out-of-pocket expenses and additional perks that fit their health and lifestyle needs.

However, it's essential to remember that lower costs are not assured. The costs largely hinge on the chosen plan and your healthcare usage. Additionally, depending on the Kaiser plan selected, there may be restrictions like needing referrals and prior authorization, which are not requirements under Original Medicare.

Extra Benefits from Kaiser

Most Kaiser Permanente Medicare Advantage plans include a variety of additional benefits to enhance overall health and wellness. Here are some of the common extra benefits offered:

What Types of Plans Does Kaiser Offer?

Not all Kaiser plans are the same. And, Kaiser may not offer all plan types where you live, so it pays to explore using our Medicare Advantage Plan Finder tool. Here are the plan types Kaiser offers:[6]

Health maintenance organization (HMO) plans require that you use a specific network of doctors and hospitals. Also, with a Kaiser HMO plan you may need a referral from your primary care doctor in order to see a specialist. Out-of-network benefits are usually very limited. However, in an emergency you are not limited to care from your local hospital of emergency room.

HMO point-of-service plans are HMO plans that allow members to get some out-of-network services, but you’ll pay more for those services.

Medicare preferred provider organization (PPO) plans provide the most freedom, allowing you to see any provider that accepts the insurance. With a PPO plan, you generally do not need to choose a primary care doctor, and you don’t need referrals to see specialists. And you can seek out-of-network care, although it may cost more than seeing an in-network doctor.

NOTE: Kaiser may also offer Medicare Advantage Special Needs Plans (SNPs). Due to the highly specialized nature of D-SNP (dual eligible), C-SNP (chronic condition), and I-SNP (institutional) insurance plans, we review them separately.

How Much Do Kaiser Plans Cost?

Kaiser's plan costs vary based on several factors, including your chosen plan, where you live, your usage, and the plan's out-of-pocket costs. Our plan finder provides detailed information about out-of-pocket costs for all Kaiser plans.

Usually, Kaiser charges a monthly premium that varies based on the coverage level and the additional benefits included. You also need to continue paying your Part B premium. Additionally, Medicare may add a monthly Income Related Monthly Adjustment Amount (IRMAA), if you're a high-income earner.[5]

Kaiser’s monthly premiums are highly dependent on where you live. For instance, the average cost of a Medicare Advantage plan from Kaiser in Georgia is $13.82 per month, but in Hawaii the average cost is $131.25 per month. These averages do not include Special Needs Plans.

Kaiser's Premiums vs. Competitors

The following list shows Kaiser's nationwide average monthly premium (excluding Special Needs Plans) vs. several competitors.

Kaiser
$13.97
Aetna
$5.51
Cigna
$17.39
Anthem
$10.11
AARP
$22.97

You also need to factor in copayments or coinsurance for healthcare services like doctor visits or hospital stays. The costs in each Kaiser plan we reviewed varied depending on the level of coverage and the type of services received.

Some plans offer $0 premiums or minimal copayments for certain services, while others might have higher premiums with lower out-of-pocket expenses. Carefully reviewing the cost and coverage details of each plan is the only way to find the one that aligns best with your needs.[7]

We analyzed the following popular Kaiser plans to give you an idea of what members pay to use healthcare services. This is just a sample, use our Medicare Advantage Plan Finder to see plans and costs where you live.

Important costs for plan ID H0524-003-0 reviewed in Orange County, CA.
  • Monthly premium: $0
  • Out-of-pocket max: $999
  • Primary Care: $$0
  • Specialist: $$0
  • Tier 1 Prescriptions: $0.00 copay, $0 deductible
  • Urgent Care: $$0
  • Emergency Room: $$0
  • Ground Ambulance: $$0
  • Inpatient Care:
  • Extra Benefits: None
Important costs for plan ID H0524-078-0 reviewed in Orange County, CA.
  • Monthly premium: $0
  • Out-of-pocket max: $1,999
  • Primary Care: $$0
  • Specialist: $$0
  • Tier 1 Prescriptions: $0.00 copay, $0 deductible
  • Urgent Care: $$0
  • Emergency Room: $$0
  • Ground Ambulance: $$0
  • Inpatient Care:
  • Extra Benefits: None

Is Kaiser a Good Medicare Advantage Plan?

Kaiser Permanente is a well-regarded provider of Medicare Advantage plans, known for its integrated care approach and focus on preventive services. The quality of these plans can vary based on individual health needs, budget, and preferences.

Several consumer intelligence companies monitor and report on health insurance companies. We’ve referenced three below.

We also looked at the Better Business Bureau (BBB), which gives Kaiser Permanente an A- rating, and consumer review websites, like ConsumerAffairs, to get a feel for the overall member experience.

J.D. Power Ranking

In its 2023 U.S. Medicare Advantage Study, J.D. Power evaluated member satisfaction with Medicare Advantage plans based on eight factors, including trust and complaint resolution. Kaiser Permanente ranked highly in several markets:[2]

  • California: 1st out of 7.
  • Colorado: 1st out of 6.
  • Mid-Atlantic: 2nd out of 5.

NCQA Health Plan Score

Every September, the National Committee for Quality Assurance (NCQA) rates health plans using a 5-point scale based on quality of care, patient satisfaction, and health plans’ efforts to improve. In its 2023 ratings, Kaiser Permanente’s plans received ratings between 4.0 and 5.0 stars, placing them among the top-rated plans nationally.[4]

AM Best Financial Strength Rating

AM Best, a credit rating agency, specializes in rating and monitoring the insurance industry. AM Best's current rating for Kaiser Permanente is A (Excellent). This rating indicates that Kaiser Permanente can meet its ongoing insurance obligations.[3]

Kaiser's Medicare Star Ratings

Kaiser's average 5-star rating: 3.93*
*Our calculation is weighted by enrollments in public plans, excluding Special Needs Plans, with CMS star ratings across 7 contracts covering 1,797,165 members.

If you're interested in the government's unbiased assessment of Kaiser's Medicare Advantage plans, you can check the Centers for Medicare and Medicaid Services' star ratings. These ratings evaluate each plan on a scale from 1 (worst) to 5 (best) stars, focusing on the quality of care and customer satisfaction, with updates provided every year.[9]

All Medicare Advantage plans are evaluated on CMS's health plan measures. Plans that include prescription drug coverage are also evaluated on drug plan measures. Based on the most recent year of data and weighted by enrollment, Kaiser’s 2024 Medicare Advantage plans get an average rating of 3.93 stars.[9] [11]

As of January 1, 2024, 80% of Kaiser members are enrolled in contracts with a Medicare star rating of 4 stars or higher.

You can view all plan ratings in your area with our Medicare Advantage Plan Finder tool.

Plan Availability

Kaiser's Medicare Advantage plans are accessible in 8 states and the District of Columbia, covering:

CA, CO, DC, GA, HI, MD, OR, VA, and WA.

Kaiser extends its coverage to 0 of the 3,140 counties across the U.S.[8]

Kaiser's Top Plans

Here's a list of Kaiser's most popular plans (by enrollments):[9][10]

Medicare Advantage Search and compare Medicare Advantage plans available in your area.

Find Plans in your area with your ZIP Code

Frequently Asked Questions

The following are the most frequently asked questions we found about Kaiser's Medicare Advantage plans:

With a Medicare Advantage plan you pay most of your costs when you use healthcare services through deductibles, copayments and/or coinsurance. As a result, private health plans can be difficult to budget. Learn More...

Some Medicare Advantage plans offer a zero-dollar monthly premium because what Medicare pays the plan, plus your Medicare Part B premium, cover the full cost. For healthy people who want to keep their monthly costs low, these plans are an attractive option. But, just be aware that the premium is not the only cost. Plans also have copays or coinsurance you must pay when you use services. To learn more about free Medicare Advantage plans, read Why are Some Medicare Advantage Plans Free?

MA Plan Pros

  1. The maximum out-of-pocket cost is $7,550 a year
  2. Many plans cost $0 extra a month
  3. Most plans include drug coverage
  4. Many include basic hearing, dental, and vision benefits
  5. May include gym discounts (Silver Sneakers)

MA Plan Cons
  1. Can only switch during Open Enrollment
  2. Not easy to compare because plans are not standardized
  3. No nationwide coverage (plans don't travel with you)
  4. Most are HMO plans that require referrals to see a specialist
  5. Plans can change health and drug coverage each year

Learn more in this article.

Researching your health plan options is important. Here are some key questions to consider before choosing a Medicare Advantage plan as well as additional companies to read about:

Key Questions

All plans potentially have monthly premiums, deductibles, copayments, and/or coinsurance, including plans from Kaiser. Are these costs within your budget?

  • Does the plan cover your prescriptions? Knowing how a plan covers them is important if you have regular prescriptions because costs and coverage vary widely from plan to plan.
  • Are your doctors in the plan’s network? If you have preferred providers, ensure they participate in the plan’s network.
  • Is routine dental, vision, and hearing covered? Traditional Medicare doesn’t cover these services. If you need it, be sure to explore plans that cover it.
  • What extras does the plan include? Plans may include many beneficial extras, like gym memberships (SilverSneakers), medical transportation, meal delivery, telehealth, and more.

Top Companies

If you have additional questions, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).

About Kaiser

Headquartered in Oakland, California, Kaiser Permanente is one of the largest nonprofit healthcare providers in the United States. Its offerings include Medicare Advantage Plans (Medicare Part C), which combine hospital (Part A) and medical (Part B) coverage with additional benefits such as prescription drug coverage (Part D), dental, and vision care.

You can enroll in a Kaiser Permanente plan during your Initial Enrollment Period (IEP) at age 65, during the annual Open Enrollment Period (Oct 15 - Dec 7), or during a Special Enrollment Period (SEP) granted under special circumstances, such as moving or losing other health coverage.

Company
Kaiser Foundation Health Plan, Inc.
Phone Number
855-832-0353
Website
https://healthy.kaiserpermanente.org/shop-plans/ready-for-medicare
Facebook Page
https://www.facebook.com/kpthrive/
X (Twitter) Page
https://x.com/aboutkp?lang=en

Citations

MedicareWire uses trustworthy sources to inform its work, including government websites, government data, actuarial service data, consumer intelligence websites, and peer-reviewed studies. All content is fact-checked for accuracy, timeliness, and relevance. We used the following information sources in this review: