Kaiser Foundation Medicare Advantage Plans Reviews
Fact checked Contributing expert: Leron Moore, Medicare consultant - Updated: Sep 02, 2021
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Quick Kaiser Foundation Medicare Advantage Plans review: Kaiser Foundation Medicare Plans provide quality, affordable health care. However, you must use the Kaiser Permanente health care network except in an emergency.
The Kaiser Foundation is one of three subsidiaries of Kaiser Permanente. These are:
- The Kaiser Foundation Health Plan offering health insurance
- Kaiser Foundation hospitals and subsidiaries
- Kaiser Permanente medical groups offering treatment
The Kaiser Foundation, established in 1945, is one of the largest not-for-profit health insurers providing coverage to 12.5 million members through its network of hospitals, medical centers, and physicians. Kaiser Permanente has a unique business model where physicians are paid a salary independent of the number of patients seen. This approach helps Kaiser provide best-of-class medical care.
Read on to learn more about Kaiser Foundation Medicare Advantage Plan options.
What do Kaiser Foundation Medicare Advantage Plans cover?
Kaiser Foundation Medicare Advantage Plans, also known as Kaiser Permanente Medicare Advantage Plans, provide alternate health insurance to Original Medicare. Medicare Advantage is commonly referred to as Medicare Part C, and minimum benefits are similar across insurers. Basic coverage is the same as Medicare Part A and Part B. Kaiser Foundation Medicare Advantage Plans include additional coverage for prescription drugs, optical care, dental treatment, and health and wellness benefits. Premiums, copays, and maximum annual out-of-pocket expenses may differ depending on your location.
What are Kaiser Foundation Medicare Advantage Plan options?
Kaiser Foundation offers three HMO Medicare Advantage Plans. With an HMO plan, you have a network of providers you need to use. This includes your primary doctor, and if you need specialist treatment, you must go to in-network providers and hospitals. In return, your medical expenses are generally lower than with other Medicare plans.
The Kaiser Foundation Advantage Plans differ in what you pay for services (your copay), additional benefits, and maximum annual out-of-pocket expenses. Depending on the plan, you’ll pay $10 per visit to your doctor and up to $50 for a specialist.
Kaiser Foundation Medicare Advantage Plans are available in eight states and Washington DC. The following table demonstrates differences between the three Kaiser Permanente HMO plans in Baltimore, MD.
|Kaiser Foundation Medicare Advantage Plans|
|Plan name||Monthly premium||Annual medical deductible||Office visits||Telehealth||Emergency room||Annual maximum out-of-pocket cost|
|Kaiser Permanente Medicare Advantage Baltimore Value (HMO)||$0||None||$10 primary care / $50 specialist||$0||$90||$7,200|
|Kaiser Permanente Medicare Advantage Standard MD (HMO)||$25||None||$10 primary care / $40 specialist||$0||$90||$6,900|
|Kaiser Permanente Medicare Advantage High MD (HMO)||$142||None||$5 primary care / $30 specialist||$0||$90||$5,700|
*Based on pricing in Baltimore City, MD.
Pros and cons of Kaiser Foundation Medicare Advantage Plans
What we like about Kaiser Foundation Medicare Advantage Plans:
- There’s no annual deductible
- Monthly premiums for Value and Standard plans are low
- Doctor, lab, and pharmacy services are often under one roof
The drawbacks of Kaiser Foundation Medicare Advantage Plans:
- You must use Kaiser Permanente network doctors and facilities
- Only three Medicare Advantage Plans
- Premiums and benefits vary depending on your state and city
Kaiser Foundation Medicare Advantage Plans reviews and ratings
Kaiser Foundation Medicare Advantage Plans have a good reputation for medical care and customer satisfaction. While you’re limited to medical care from the Kaiser Permanente network, except in an emergency, you benefit from lower costs and no annual deductibles.
The National Committee for Quality Assurance (NCQA) rates Kaiser Foundation Medicare Health Plans highly, with plans in three states scoring 5 out of 5 and in others 4.5 out of 5. Customer satisfaction ratings are slightly lower at 3.5, but this is compensated by higher ratings for prevention and treatment. Kaiser Foundation Plans have NCQA accreditation.
The Better Business Bureau (BBB) rates Kaiser Permanente at A+, its highest rating. This rating reflects positively on how Kaiser Permanente interacts with its members.
Customer reviews on Consumer Affairs give Kaiser Permanente a 4 out of 5 rating. Based on 2,103 ratings over the last year, reviewers expressed high satisfaction levels with the quality of care and low medical costs. A few reviewers complained of poor administration and unsatisfactory arbitration processes.
- Featured Sources [-]
Consumer Affairs | Kaiser Permanente | Last Accessed August 2021
Kaiser Permanente | Fast Facts | Last Accessed August 2021
Kaiser Permanente | HMO vs. PPO plans – what are the differences? | Last Accessed August 2021
Medicare Advantage Plans | Who Qualifies for Medicare Advantage Plans? | Last Accessed August 2021
gov | Medicare Advantage Plans | Last Accessed August 2021
NCQA | Kaiser Foundation Health Plans | Last Accessed August 2021
Leron Moore, Medicare consultant
Leron Moore has guided Medicare beneficiaries and their families as a Medicare professional for nearly 15 years. First as a Medicare provider enrollment specialist, and now a Medicare account executive, Moore works directly with Medicare beneficiaries to ensure they understand Medicare and Medicare Advantage Plans.