Kaiser Foundation Medicare Advantage Plans Review

Fact Checked
Medicare rating: 5 stars A.M. Best financial strength rating: A BBB rating: A- NCQA rating: 4.5 to 5 stars Consumer Affairs rating: 4 J.D. Power ranking: 1st out of 10

Quick Kaiser Permanente Medicare Advantage plans review: Kaiser Permanente offers Medicare Advantage Plans that emphasize coordinated care, but options are limited to eight states.

Kaiser Permanente started in 1945 as a health care program for local workers in California. After WWII, the company expanded to include public members. Kaiser Permanente has several subsidiaries, all working together to provide affordable, premier health care to its members. The Foundation Health Plan manages the company’s insurance aspect, while the Kaiser Foundation Hospitals and Permanente Medical Groups provide expert medical care. The company works on a coordinated-care model, offering its members hospital, pharmacy, and doctor services, all of which accept Kaiser’s insurance offerings.

The company provides Medicare Advantage Plans in Colorado, California, Hawaii, Washington, Georgia, Virginia, Maryland, Oregon, and Washington D.C. Plan choices will vary by region and counties in some states, but all are Health Maintenance Organizations (HMOs).

Pros and Cons of Kaiser Permanente Medicare Advantage Plans

What we like about Kaiser Permanente Medicare Advantage Plans: The drawbacks of Kaiser Permanente Medicare Advantage Plans:
  • High-performance ratings and customer reviews
  • Low premiums for the base plan
  • No annual deductible
  • Injectable Part D vaccines
  • Coverage limited to eight states plus Washington D.C.
  • Only HMO options are available

What Do Kaiser Permanente Medicare Advantage Plans Cover?

Also called Medicare Part C, Medicare Advantage Plans combine Part A and B benefits with various extra services. Part B benefits are subject to the annual deductible ($233 in 2022) and copays. Medicare-covered services apply toward your out of pocket max. Kaiser Permanente Medicare Advantage Plans also include these services not typically covered by Medicare:

  • Prescription drug coverage (mail-order pharmacy included)
  • Vision
  • Dental
  • Hearing
  • Wellness benefits, such as free gym memberships
  • Medical transportation
  • Wellness over-the-counter medications
  • Worldwide emergency
  • Telehealth

Kaiser Permanente Medicare Advantage Plan Options

Kaiser Permanente offers three levels of its Medicare Advantage HMO Plans — Senior Advantage Core, Senior Advantage Silver, and Senior Advantage Gold. Since these are HMOs, you enjoy cost savings as compared to other more expensive plan types, such as PFFS and PPOs. However, you will need to choose a primary care physician, and you’ll have to stay in-network to receive coverage. Members of an HMO typically must get a referral from their PCP to visit a specialist.

All three of Kaiser’s HMO options have prescription drug coverage, no annual deductible, and free primary doctor and telehealth visits. Monthly premiums for the Silver and Gold plans are lower in 2022 compared to 2021.

Compare your 2022 Kaiser Permanente Medicare Advantage plan options:

Plan name Monthly premium Annual deductible Office visits Annual maximum out-of-pocket cost
Kaiser Permanente Senior Advantage Core (HMO) $0 None $0 primary/$20 specialist $4,200
Kaiser Permanente Senior Advantage Silver (HMO) $38 None $0 primary/$15 specialist $3,400
Kaiser Permanente Senior Advantage Gold (HMO) $186 None $0 primary/$10 specialist $3,000

*Based on pricing in Denver, CO

Kaiser Permanente Medicare Advantage Plans Reviews and Ratings

Kaiser Permanente isn’t just a health insurance company; it’s one of the largest managed care organizations in the United States with its own network of hospitals and medical providers. Your plan premiums directly fund the hospitals and medical offices, so there should be no issues with unexpected bills or denial of coverage for care that you receive within its network.

Trusted ratings and reviews can help you understand how an insurer’s plans stack up against the competition. See how Medicare, A.M. Best, the Better Business Bureau and more rate Blue Cross Blue Shield (BCBS) Medicare plans.

Medicare rating: 5 stars Kaiser’s Medicare Advantage Plans in all coverage areas have an overall quality rating of 5 stars from the Centers for Medicare & Medicaid Services.
A.M. Best financial strength rating: A A.M. Best is a credit rating agency specializing in the insurance industry. Kaiser and its subsidiaries earned an A rating from A.M. Best.

An A rating indicates stability to meet ongoing obligations.

BBB rating: A- Kaiser Permanente, while not accredited, has an A- rating with the Better Business Bureau with 77 complaints closed in the last three years.
NCQA rating: 4.5 to 5 stars Kaiser has received high rankings from the National Committee for Quality Assurance. Colorado and California plans show a 5.0, and the remaining areas serviced by Kaiser have earned 4.5. Both place the insurer in the Higher Performance category.
Consumer Affairs rating: 4 Consumer Affairs, a noted review agency, collects and verifies customer experiences for many business enterprises. According to customer satisfaction ratings, Kaiser Permanente earns four out of five stars. Customers felt their premiums were reasonable and bills were reconciled correctly and in a timely fashion.
J.D. Power ranking: 1st out of 10 In its 2021 Medicare Advantage Study, J.D. Power measured Medicare Advantage Plan satisfaction based on coverage and benefits, provider choice, cost, customer service, information and communication, and billing and payment. Kaiser Foundation Health Plan scored 846 points out of 1,000 and came in first out of the top 10 Medicare Advantage providers.
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Certified Senior Advisor (CSA)Ⓡ

As a health care professional since 1987, Kelly Blackwell has walked alongside and cared for seniors as they journey through the season of their fourth quarter of life. Blackwell holds a Bachelor of Science in nursing from the University of Northern Colorado, a Master of Science in health care administration from Grand Canyon University, an interprofessional graduate certificate in palliative care from the University of Colorado Anschutz Medical Campus and holds a Certified Senior Advisor® credential from the Society of Certified Senior Advisors.

Blackwell contributes to the University of Colorado-Anschutz blog and has been published in “The Human Touch” distributed by the University of Colorado Center for Bioethics and Humanities. She cowrote “Dying Is” for Pathways Hospice.

A registered nurse, Blackwell understands health insurance choices influence quality of life and are driven by values, goals, and beliefs. She’s passionate about engaging with, educating, and empowering seniors as they navigate the health care system. She’s equipped to lend an experienced, compassionate voice to beneficiaries seeking information about Medicare Advantage Plans.

As a CSAⓇ, Blackwell has access to valuable resources for Medicare beneficiaries. Her work as a bedside nurse and clinical manager has given her the opportunity to see how Medicare rules, regulations, and benefits work when patients need them. With a passion to learn and to make a difference in the lives of seniors, Blackwell supports seniors through Medicare and fourth-quarter life decisions.

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