Kaiser Permanente Medicare Advantage Plans 2025

Are you considering Kaiser Permanente Medicare Advantage plans in 2025 for your healthcare needs?

With over 1.8 million Medicare beneficiaries enrolled in their plans, it’s clear that many people find value in what Kaiser Permanente has to offer.

In this article, we will guide you through the various aspects of these Kaiser Permanente Medicare Advantage plans, from coverage options to enrollment processes, helping you make an informed decision about your healthcare future.

So, let’s embark on this journey together and find the perfect fit for your needs!


Key Takeaways

  • Kaiser Permanente’s Medicare Advantage plans offer comprehensive coverage, strong customer satisfaction ratings, and financial stability.


  • Evaluate premiums, copays, coinsurance, and deductibles to determine associated costs when selecting a plan.


  • Consider factors such as in-network doctors & specialists availability, prescription drug coverage & extra benefits for the best option that meets your healthcare needs & budget.

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Understanding Kaiser Permanente Medicare Advantage Plans

Kaiser Permanente is a well-known healthcare company that provides insurance to millions of individuals across eight states and Washington, D.C.

Their Medicare Advantage plans are popular choices for those seeking comprehensive coverage and excellent customer satisfaction.

One of the key advantages of these plans is the integrated care model utilized by Kaiser Permanente, allowing members to access all their care from a single location and providers to be interconnected within Kaiser’s network.


Understanding Kaiser Permanente Medicare Advantage Plans

As a healthcare provider, Kaiser Permanente has earned a solid reputation and has reported total operating revenues of $95.4 billion in 2022.

With such strong backing, it’s no wonder that so many Medicare beneficiaries trust Kaiser Permanente with their healthcare needs.

For a clearer understanding of the options at your disposal, we will further examine the types of plans, coverage, and availability of Kaiser Permanente Medicare Advantage plans.


Plan Types

Kaiser Permanente primarily offers Health Maintenance Organization (HMO) plans, which are structured around a network of hospitals, physicians, and other healthcare providers that collaborate on care within the network.

This means that members generally need to see in-network providers to receive coverage, ensuring that all care is coordinated and streamlined.

In contrast, Preferred Provider Organization (PPO) plans offer greater flexibility, allowing members to visit providers outside the network, but they are usually more costly than HMO plans.

Apart from HMO and PPO plans, Kaiser Permanente also provides a distinct plan type known as a Special Needs Plan (SNP).

Their Dual-Eligible SNP is tailored to members who have certain diseases or characteristics and are entitled to Medicare while also qualifying for assistance from a state Medicaid program. This type of plan offers numerous benefits, such as:


  • Combining multiple coverages
  • Coordinating Medicare and Medicaid benefits
  • Creating new possibilities to enhance health outcomes and experiences for dually eligible individuals.



While evaluating a Kaiser Permanente Medicare Advantage plan, understanding the diverse types of Medicare coverage offered is necessary. Most plans include:


  • Prescription drug coverage, which is crucial for those who regularly take medications
  • Dental coverage, providing services like teeth cleanings, dental X-rays, and dentures
  • Vision services, such as routine eye exams and coverage for glasses or contact lenses


These are vital aspects of Kaiser Permanente Medicare Advantage plans.


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Beyond basic coverage, Kaiser Permanente Medicare Advantage plans also proffer discounted services, programs, and resources at no extra cost, complemented with extensive coverage and support for your healthcare requirements.

While there may be limitations or exceptions to the coverage provided, it’s essential to consult the Evidence of Coverage document for your chosen plan to understand the specific details and restrictions.



Kaiser Permanente Medicare Advantage plans are offered in several US states including:



These health plans offer members comprehensive coverage and a range of healthcare services. It’s worth noting that, at this time, there is no information available regarding plans to expand to other states.

Be sure to check the availability of these plan covers in your region to ensure you can access the coverage and benefits that best suit your needs.

Analyzing the Costs: Kaiser Permanente Medicare Advantage Plans


Kaiser medicare advantage cost While assessing a Kaiser Permanente Medicare Advantage plan, it is necessary to take into account the costs linked with the plan type, geographical area, and individual health prerequisites.

The typical premiums for Kaiser Permanente Medicare Advantage plans range from $44 to $127 per month.

But these costs can vary depending on your location and specific plan.

To gain a complete understanding of the expenses tied to a Kaiser Permanente Medicare Advantage plan, we will go into the specifics of premiums, copays, coinsurance, and deductibles.




Some Kaiser Permanente Medicare Advantage plans offer $0 premiums, making them an attractive choice for those on a budget.

However, it’s important to remember that Medicare Part B premiums still apply and currently stand at $174.70 per month in 2024.

These premiums are subject to change annually, so it’s vital to stay informed about any adjustments to ensure you can continue to afford your chosen plan.


Copays, Coinsurance, and Deductibles

The out-of-pocket costs for a Kaiser Permanente Medicare Advantage plan include:


  • Copays: a fixed fee for a covered service, such as a doctor’s visit or prescription medication
  • Coinsurance: a percentage of the cost of a covered service, typically after the deductible is met
  • Deductibles: the amount that must be paid out of pocket for covered services before the plan begins to pay


These costs significantly impact the total cost of the plan.

These costs can vary depending on the specific plan and location, so it’s essential to review the details of each plan to gain an understanding of the costs associated with it.

For example, the average copay for primary doctor visits under Kaiser Permanente Medicare Advantage plans is $5, while the average copay for specialist visits is $35.

It’s always a good idea to compare the costs of different plans to ensure you’re making the best choice for your healthcare needs and budget.

Evaluating Kaiser Permanente’s Medicare Star Ratings

The Medicare Star Rating system is a valuable tool for comparing the quality of Medicare health and drug plans. Here are some key points to consider:


  • The ratings range from one to five stars, with five being the highest score a plan can receive.
  • When evaluating Kaiser Permanente’s Medicare Advantage plans, it’s important to consider their star ratings.
  • The star ratings reflect the quality of care and customer satisfaction provided by the plan.


This section will cover the overall rating for Kaiser Permanente’s Medicare Advantage plans and the factors influencing these ratings.


Overall Rating

Kaiser Permanente’s 2024 Medicare Advantage plans have an overall star rating of 3.94. This rating takes into account:


  • Clinical outcomes
  • Effectiveness of care
  • Health services rating
  • Drug services rating
  • Percentage of members in plans rated four stars or higher


This demonstrates their commitment to providing quality health care, including urgent care, to their members.

While other providers may have higher star ratings, it’s important to remember that a 3.94 rating still represents strong performance and customer satisfaction in the realm of Medicare Advantage plans.


Quality of Care and Customer Satisfaction

Kaiser medicare advantage 2024 The Medicare Star Ratings take into account factors such as quality of care, patient satisfaction, and health plan performance when determining the overall rating for a plan.

For example, quality of care is assessed through preventive care, chronic care, member complaints, mortality, safety of care, readmission, and patient experience metrics.

When it comes to patient satisfaction, Kaiser Permanente has consistently been rated highest in Medicare Advantage member satisfaction, according to studies and surveys.

Health plan performance is another essential aspect of the Medicare Star Ratings. It encompasses:


  • The plan’s star rating from the Centers for Medicare & Medicaid Services (CMS)
  • Preventive care and chronic disease management
  • Customer satisfaction
  • Overall quality of care


Kaiser Permanente’s Medicare Advantage plans, which are part of their Kaiser Permanente Medicare Health offerings, have consistently demonstrated high ratings and recognition for their performance and quality of care, making them a solid choice for those seeking a well-rounded healthcare plan.

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Third-Party Assessments of Kaiser Permanente Medicare Advantage Plans

In addition to the Medicare Star Ratings, third-party assessments can provide valuable insights into the financial strength and customer satisfaction of Kaiser Permanente Medicare Advantage plans.

These assessments come from independent organizations like Fitch Ratings, J.D. Power, and the National Committee for Quality Assurance (NCQA).

This section will examine these third-party assessments and their revelations about the quality and performance of Kaiser Permanente Medicare Advantage plans.


Fitch Ratings

Fitch Ratings, a credit rating agency, assigned a strong AA- rating to Kaiser Foundation Health Plan in June 2023.

This rating indicates high credit quality and a minimal risk of default, meaning that Kaiser Permanente has a robust ability to meet its financial obligations.

The AA- rating also suggests a slightly lower credit quality compared to a straight AA rating, but it still demonstrates the financial stability and strength of the Kaiser Foundation Health Plan.


J.D. Power Ranking

Another third-party assessment comes from J.D. Power, which ranked Kaiser Foundation Health Plan third among all major providers in California for Medicare Advantage satisfaction. J.D.


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Power evaluates Medicare Advantage plans based on overall satisfaction scores generated from a 1,000-point scale, using surveys and feedback from plan members within Kaiser’s network.

This high ranking further emphasizes the quality and customer satisfaction provided by Kaiser Permanente Medicare Advantage plans.


NCQA Score

The National Committee for Quality Assurance (NCQA) is a nonprofit organization that aims to improve the quality of healthcare in the United States.

They awarded Kaiser Permanente plans a score of 4.5 out of 5, demonstrating their commitment to providing high-quality care.

This score is based on clinical quality measures, consumer experience, and performance standards, further highlighting the excellence and reliability of Kaiser Permanente Medicare Advantage plans.

Navigating the Enrollment Process

Enrolling in a Kaiser Permanente Medicare Advantage plan involves understanding the enrollment periods and using resources to compare plans before making a decision.

The primary enrollment periods for these plans include the annual Medicare Open Enrollment Period, which runs from October 15th to December 7th annually, and the Initial Enrollment Period for new Medicare beneficiaries.

This section will cover the different enrollment periods and resources obtainable to aid you in selecting the appropriate plan for your needs.


Enrollment Periods

Does kaiser permanente accept medicare and medicaid Being aware of the different enrollment periods is essential when considering a Kaiser Permanente Medicare Advantage plan.

The Annual Election Period, which occurs from October 15th to December 7th each year, is the designated time frame when you can make changes to your plan for the upcoming year. If you enroll during this period, your coverage will commence on January 1st of the following year.

In addition to the Annual Election Period, there are also Special Enrollment Periods, which allow you to enroll in or make changes to your plan outside of the annual enrollment window due to certain qualifying events.

These events may include changes in your life, such as moving to a new location, losing your current coverage, or experiencing a change in your financial situation.

Be sure to stay informed about the various enrollment periods to ensure you can access the coverage and benefits that best suit your needs.


Resources for Comparing Plans

When choosing a Medicare Advantage plan, it’s important to compare the available options to find the best fit for your needs.

One of the most comprehensive resources for comparing Kaiser Permanente Medicare Advantage plans is Medicare’s website, which allows you to view and compare plans offered in your area.

By using this tool, you can gain valuable insight into the costs, coverage, and ratings of various plans, helping you make an informed decision about your healthcare future.

Customer Support Options

Kaiser Permanente offers multiple customer support options for Medicare Advantage plan members, including phone, chat, and email support.

Whether you have questions about your plan, need assistance with claims, or require guidance on navigating the healthcare system, Kaiser Permanente’s customer support team is ready to help.

You can reach their customer service at 1-888-901-4636 or access live chat support via their website. Don’t hesitate to reach out for the support you need to make the most of your healthcare experience.


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Tips for Choosing the Right Medicare Advantage Plan

When selecting the right Medicare Advantage plan, it’s crucial to consider various factors, such as:


  • Costs
  • In-network providers
  • Prescription drug coverage
  • Additional benefits


By carefully evaluating these aspects, you can ensure that you’re choosing a plan that aligns with your healthcare needs and financial situation.

The subsequent subsection will cover some key factors to bear in mind when assessing and selecting a Kaiser Permanente Medicare Advantage plan.


Factors to Consider


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First, it’s essential to evaluate the premiums, copays, and deductibles associated with each plan, as these costs can have a significant impact on your overall healthcare expenses.

When comparing plans, make sure to also consider the availability of in-network doctors and specialists, as well as the coverage of prescription drugs, to ensure that your medical needs are met.

Extra benefits, such as dental and vision coverage, can also play a role in your decision, as they can provide added value to your healthcare experience.

In addition to these factors, it’s important to review the Medicare Star Ratings and third-party assessments, such as those from Fitch Ratings, J.D. Power, and the NCQA, to gain a comprehensive understanding of the quality and performance of each plan.



By taking the time to research and compare your options, you can make an informed decision and select the Medicare Advantage plan that best fits your needs and budget.


In conclusion, Kaiser Permanente Medicare Advantage plans offer a variety of options, coverages, and availability to suit the diverse needs of their members.

With consistently high ratings and strong financial backing, these plans provide a reliable solution for your healthcare needs.

To choose the right plan, be sure to consider factors such as costs, in-network providers, prescription drug coverage, and additional benefits, as well as the various enrollment periods and customer support options available.

By carefully evaluating your options and using resources like Medicare’s website, you can confidently select the Kaiser Permanente Medicare Advantage plan that best fits your needs. So, don’t wait; take control of your healthcare future and find the plan that will help you live your healthiest life!

Frequently Asked Questions



Is Kaiser Senior Advantage the same as Medicare Advantage?

Kaiser Senior Advantage is a Medicare Advantage plan, that replaces traditional Medicare coverage with an HMO closed network of providers.


Is Kaiser a good choice for Medicare?

Kaiser’s Medicare Advantage plans have earned a 5-star rating from the CMS and are highly rated in the J.D. Power U.S. Medicare Advantage Study, making it a great choice for Medicare. Most of the plans include drug coverage and 8 out of 10 members are in a plan rated 4 stars or higher.


Does Kaiser take United Healthcare?

Unfortunately, Kaiser and United Healthcare are not compatible – you cannot use the services of one if you have coverage with the other.

It ultimately comes down to the provider network you prefer, so if you have existing relationships outside of Kaiser, United Healthcare might be a better choice.


What is Kaiser Permanente Senior Advantage Summit 2023?

The Kaiser Permanente Senior Advantage Summit 2023 is a Medicare health care and prescription drug coverage plan available in California for the year 2023 with a $0 copay for most services.

However, copays remain for emergency room visits, pharmacy benefits, acupuncture, and chiropractic.


What types of Kaiser Permanente Medicare Advantage plans are available?

Kaiser Permanente offers Health Maintenance Organization (HMO) plans, Preferred Provider Organization (PPO) plans, and Special Needs Plans (SNPs) for Medicare Advantage customers.

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Russell Noga
( Medicare Expert )

Russell Noga is the CEO of ZRN Health & Financial Services, and head content editor of several Medicare insurance online publications. He has over 15 years of experience as a licensed Medicare insurance broker helping Medicare beneficiaries learn about Medicare, Medicare Advantage Plans, Medigap insurance, and Medicare Part D prescription drug plans.