Kaiser Permanente Medicare Advantage High MD (HMO-POS) Medicare Advantage Plan H2172-002 • 2027 • Frederick County, MD
- Monthly Premium
- $114.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $5700.00In-network
- Part B Giveback
- Not offered
- Prescription Coverage
- Enhanced, $0.00 deductible
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Frederick County, MD
- Local Enrollment
- 110 beneficiaries in Frederick County
Kaiser Permanente Medicare Advantage High MD (HMO-POS) Introduction
CMS Plan ID H2172-002 identifies Kaiser Permanente Medicare Advantage High MD, a Medicare Advantage HMO-POS plan offered by Kaiser Permanente. The plan uses a Health Maintenance Organization with a Point of Service (HMO-POS) provider network and comes with prescription drug coverage. Its costs for the 2027 plan year include a $114.00 monthly premium, $0.00 medical deductible, and $5700.00 in-network maximum out-of-pocket. The 2027 Part D prescription drug deductible is $0.00.
This plan is available to eligible beneficiaries who live in Frederick County, Maryland. CMS reports local enrollment of 110 beneficiaries for this plan in Frederick County. New members can contact the plan at (877)408-8607 (TTY 711) for help and additional plan information.
Compare Similar Plans in Frederick County
Compare this plan with the most-enrolled other HMO-POS plan available in Frederick County, Maryland. Enrollment is based on CMS local enrollment data.
| Plan Detail | Kaiser Permanente Medicare Advantage High MD | Kaiser Permanente Medicare Advantage Standard 1 MD |
|---|---|---|
| CMS Plan ID | H2172-002-0 |
H2172-021-0 |
| Local Enrollment | 110 | 616 |
| Monthly Premium | $114.00 | $32.00 |
| Medical Deductible | Coming soon | Coming soon |
| Maximum Out-of-Pocket | $5,700.00 | $7,900.00 |
| Part B Giveback | Coming soon | Coming soon |
| Primary Care | Coming soon | Coming soon |
| Specialist | Coming soon | Coming soon |
| Part D Deductible | $0.00 | $0.00 |
| CMS Star Rating | 4.5 | 4.5 |
| Dental | Coming soon | Coming soon |
| Vision | Coming soon | Coming soon |
| Hearing | Coming soon | Coming soon |
Looking for additional Medicare Advantage options? Explore other plans available in Frederick County, or visit our Maryland Medicare Advantage plan directory for statewide comparisons of premiums, out-of-pocket costs, CMS ratings, and enrollment.
Plan Benefits
Kaiser Permanente Medicare Advantage High MD has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The tables below detail the most common in-network out-of-pocket expenses for plan H2172-002.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H2172-002-0 Cost Compare.
Office Visits
- Primary care
- In-network: $0 copay
Out-of-network: $0-$25 copay - Specialist
- In-network: $30 copay
Out-of-network: $0-$65 copay
Preventive and Wellness Services
- Annual wellness exam
- In-network: $0 copay
Out-of-network: $0-$25 copay - Telehealth benefit
- In-network: $0 copay
- Routine chiropractic
- Not covered
- Fitness benefits
- Coming soon
- Health education
- In-network: $0 copay
- Counseling services
- Not covered
- Over-the-counter drug benefits
- In-network: $0 copay
- Health transportation (non-emergency)
- Coming soon
Diagnostic, Lab, and Imaging Services
- Diagnostic radiology services
- In-network: $10-$200 copay
Out-of-network: $0-$50 copay - Lab services
- In-network: $0 copay
Out-of-network: $0-$50 copay - Outpatient x-rays
- In-network: $10 copay
Out-of-network: $0-$50 copay - Diagnostic tests and procedures
- In-network: $0 copay
Out-of-network: $0-$50 copay
Emergency and Urgent Care Services
- Emergency room care
- $130 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $30 copay
- Inpatient hospital care
- In-network:
Tier 1
$300 per day for days 1-6
$0 per day for days 7-90
$0 per stay - Skilled Nursing Facility
- In-network:
Tier 1
$0 per day for days 1-20
$221 per day for days 21-100 - Ground ambulance
- In-network: $225 copay
Mental Health Services
- Outpatient individual therapy
- In-network: $10 copay
Out-of-network: $15-$25 copay - Outpatient group therapy
- In-network: $5 copay
Out-of-network: $15-$25 copay - Inpatient psychiatric hospital care
- In-network:
Tier 1
$300 per day for days 1-6
$0 per day for days 7-90
$0 per stay
Rehabilitation Services
- Physical therapy and speech and language therapy
- In-network: $30 copay
Out-of-network: $0-$65 copay - Occupational therapy
- In-network: $30 copay
Out-of-network: $0-$65 copay
Medical Equipment and Supplies
- Diabetes supplies
- In-network: 0% coinsurance
- Durable medical equipment
- In-network: 0%-20% coinsurance
- Prosthetics
- In-network: 20% coinsurance
Medicare Part B Drugs
- Chemotherapy
- In-network: $12-$47 copay, 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance - Other Part B drugs (Medicare-covered)
- In-network: $12-$47 copay, 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance
Dental Services
- Oral exam
- In-network: $0 copay
- Dental x-rays
- In-network: $0 copay
- Cleaning
- In-network: $0 copay
- Periodontics
- In-network: 50% coinsurance
- Endodontics
- In-network: 50% coinsurance
- Restorative services
- In-network: 50% coinsurance
- Implant services
- Not covered
- Orthodontics
- Not covered
- Oral/Maxillofacial surgery
- In-network: 50% coinsurance
Vision Services
- Routine eye exam
- In-network: $0-$30 copay
- Contact lenses
- In-network: $0 copay
- Eyeglass frames only
- In-network: $0 copay
- Eyeglass lenses only
- In-network: $0 copay
- Eyeglasses (frames & lenses)
- In-network: $0 copay
- Upgrades
- Not covered
Hearing Services
- Hearing exam
- Not covered
- Fitting/evaluation
- In-network: $0 copay
- Prescription hearing aids
- In-network: $0 copay
- OTC hearing aids
- Not covered
Additional and Special Needs Services
- Adult day health services
- Not covered
- Home-based palliative care
- In-network: $0 copay
- Personal emergency response system
- Coming soon
- Weight management programs
- Not covered
- Wigs for chemotherapy-related hair loss
- Coming soon
- Alternative therapies
- Not covered
- Massage therapy
- Not covered
- Home/bathroom safety devices
- Not covered
Certain preventive services are covered 100% by Kaiser Permanente Medicare Advantage High MD as a Part B benefit.
Prescription Drug Coverage
Kaiser Permanente Medicare Advantage High MD includes a Medicare Part D prescription drug plan (PDP). Plan type and coverage level are defined by CMS and may vary between basic and enhanced benefit designs.
This plan includes an enhanced benefit Medicare Part D plan (PDP), providing coverage beyond the standard CMS-defined minimum.
Prescription Drug Plan Premium
The Part D prescription drug plan premium is included in the overall Medicare Advantage plan cost. Additional adjustments may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help, administered by Social Security. LIS benefits are separate from Medicare Special Needs Plan coverage.
| Part D Premium Component | Amount |
|---|---|
| Basic Part D Premium: | $0.00 |
| Supplemental Part D Premium: | $$0.00 |
| Total Part D Premium: | $0.00 |
| Low-Income Premium Subsidy: | $7.88 |
| Low-Income Premium Subsidy Paid by CMS: | $0.00 |
| Low-Income Subsidy Premium: | $0.00 |
For more details, visit the Social Security Extra Help program .
Prescription Drug Plan Deductible
This plan has a $0.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Kaiser Permanente starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, Kaiser Permanente Medicare Advantage High MD may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic | $0.00 copay | Coming soon |
| Generic | $12.00 copay | Coming soon |
| Preferred Brand | $42.00 copay | Coming soon |
| Non-Preferred Drug | $100.00 copay | Coming soon |
| Specialty Tier | 29% coinsurance | Coming soon |
| Vaccines | $0.00 copay | Coming soon |
| *Deductible does not apply. | ||
CMS 5-Star Performance Ratings (Contract ID: H2172)
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.
| CMS Measure | Star Rating |
|---|---|
| 2027 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
Contact Information for Kaiser Permanente
- Website
- Kaiser Permanente Plan Page
- Providers
- Kaiser Permanente Providers Page
- Formulary
- Kaiser Permanente Formulary Page
- Pharmacy
- Kaiser Permanente Pharmacy Page
- New Member Health Plan Help
- (877)408-8607
- New Member Health Plan TTY
- 711
- New Member Part D Help
- (877)408-8607
- New Member Part D TTY Users
- 711
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.
Medicare Advantage Plan Availability
Kaiser Permanente Medicare Advantage High MD is available to eligible Medicare beneficiaries residing in Frederick County, Maryland, including communities such as Frederick, Adamstown, Brunswick, Emmitsburg, Ijamsville, Jefferson, Knoxville, Middletown, Monrovia, Mount Airy, Myersville, New Market, Sabillasville, Thurmont, Walkersville, Woodsboro, and other areas throughout the county. Enrollment eligibility is based on county of residence, not city.
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | October 5, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| Kaiser Permanente (official source) | http://kp.org/medicare | October 4, 2026 |
| CMS.gov | Medicare Advantage Plan Fact Sheet | 25 May, 2025 |
| Medicare.gov | Joining a plan | 25 May, 2025 |
| Medicare.gov | Explore your Medicare coverage options | 25 May, 2025 |
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