Kaiser Permanente Senior Advantage Liberty (HMO) Medicare Advantage Plan H1170-014 • 2026 • Paulding County, GA

Kaiser Permanente Senior Advantage Liberty Overview

Coverage Overview for Kaiser Permanente Senior Advantage Liberty

Kaiser Permanente Senior Advantage Liberty is a Medicare Advantage HMO plan that provides Medicare Part A and Part B coverage through a network of participating providers. The monthly premium is $0.00, and the plan generally requires selection of a primary care provider (PCP) and use of in-network services, except in emergency situations.

Primary care visits have a $0 copay, specialist visits come with a $0-$40 copay, urgent care services carry a $40 copay, and ambulance transportation is $225 copay. These costs apply toward the maximum out-of-pocket (MOOP) limit of $6000.00. After this limit is reached, in-network services are fully covered.

This plan is listed by CMS under Plan ID H1170-014. A summary of cost sharing is provided below.

Cost-Sharing Overview

Cost-sharing for Kaiser Permanente Senior Advantage Liberty includes out-of-pocket expenses for covered healthcare services. The table below provides a summary of typical in-network out-of-pocket costs for plan H1170-014.

Certain preventive services are covered 100% by Kaiser Permanente Senior Advantage Liberty as a Part B benefit.

Prescription Drug Coverage

This plan does not include a Medicare Part D plan for prescriptions.

CMS 5-Star Ratings

CMS evaluates Medicare Advantage (Part C) and Part D plans annually using a 5-star rating system. Ratings reflect performance in preventive care, chronic condition management, and member experience.