Medicare Advantage health plans
Medicare Advantage health plans
Enroll today and receive lower premiums and new benefits for 2021
We’re pleased to introduce Kaiser Permanente Medicare Advantage (HMO) plans in 2021. Medicare Advantage (also known as Medicare Part C) is a nationally recognized managed care option. It helps millions of Medicare beneficiaries stay healthy with coverage for hospitalization, medical care, and prescription drugs.
Plans for Virginia
BENEFIT
2020 Medicare Plus (COST) Plan
2020 Medicare Advantage (HMO) Plan
Physician options
To receive benefits of the Kaiser Permanente Medicare Plus (Cost) plan, you must use Mid-Atlantic Permanente Medical Group physicians and affiliates.
You may go to any other provider who accepts Medicare and receive Original Medicare benefits.
To receive benefits of the Kaiser Permanente Medicare Advantage plan, you must use Mid-Atlantic Permanente Medical Group physicians and affiliates.
No benefits for other providers.
NOTE: If you are already scheduled for treatment after January 1, 2020 with a provider who is not part of the Kaiser Permanente Medicare Advantage network, please download and fill out the Continuity of Care Form in Helpful Documents and contact Member Services at 1-888-777-5536 (TTY 711), Monday through Friday, 8 a.m. to 8 p.m. so we can determine if you are eligible to temporarily continue care with that provider.
Network hospitals in the District of Columbia, Maryland, and Virginia
13
18
Monthly plan premium
$54 for Standard plan with Part D
$142 for High plan with Part D
Value plan with Part D
$0 for residents of Virginia
Standard plan with Part D
$25 for residents of Virginia
High plan with Part D
$142 for residents of Virginia
Maximum out-of-pocket amount
Standard plan with Part D
$6,700
High plan with Part D
$5,000
Value plan with Part D
$6,700
Standard plan with Part D
$6,700
High plan with Part D
$5,500
Doctor office visits
Standard plan with Part D
Primary care visits:
$10 per visit
Specialist visits:
$45 per visit
High plan with Part D
Primary care visits:
$5 per visit
Specialist visits:
$30 per visit
Value plan with Part D
Primary care visits:
$15 per visit
Specialist visits:
$45 per visit
Standard plan with Part D
Primary care visits:
$5 per visit
Specialist visits:
$35 per visit
High plan with Part D
Primary care visits:
$5 per visit
Specialist visits:
$30 per visit
Inpatient hospital stays
Standard plan with Part D
$850 per benefit period
High plan with Part D
$350 per benefit period
Value plan with Part D
You pay $275 a day for days 1-5; no charge for the remainder of your stay.
Standard plan with Part D
You pay $250 a day for days 1-5; no charge for the remainder of your stay.
High plan with Part D
You pay $200 a day for days 1-5; no charge for the remainder of your stay.
Silver&Fit3 gym membership and at-home fitness program
Included
Included for Standard and High plans.
Not available for Value plan.
Advantage Plus enhanced dental, hearing, and vision benefits
Available for a monthly $25 fee
Available for a monthly $25 fee
Part D prescription drug coverage
Preferred cost-sharing during the initial coverage stage (up to a 30-day supply):
Standard plan with Part D
Drug Tier 1:
$7
Drug Tier 2:
$15
High plan with Part D
Drug Tier 1:
$2
Drug Tier 2:
$15
Value plan with Part D
Drug Tier 1:
$5
Drug Tier 2:
$15
Standard plan with Part D
Drug Tier 1:
$3
Drug Tier 2:
$12
High plan with Part D
Drug Tier 1:
$5
Drug Tier 2:
$15
Plans for Maryland
BENEFIT
2020 Medicare Plus (COST) Plan
2020 Medicare Advantage (HMO) Plan
Physician options
To receive benefits of the Kaiser Permanente Medicare Plus (Cost) plan, you must use Mid-Atlantic Permanente Medical Group physicians and affiliates.
You may go to any other provider who accepts Medicare and receive Original Medicare benefits.
To receive benefits of the Kaiser Permanente Medicare Advantage plan, you must use Mid-Atlantic Permanente Medical Group physicians and affiliates.
No benefits for other providers.
NOTE: If you are already scheduled for treatment after January 1, 2020 with a provider who is not part of the Kaiser Permanente Medicare Advantage network, please download and fill out the Continuity of Care Form in Helpful Documents and contact Member Services at 1-888-777-5536 (TTY 711), Monday through Friday, 8 a.m. to 8 p.m. so we can determine if you are eligible to temporarily continue care with that provider.
Network hospitals in the District of Columbia, Maryland, and Virginia
13
18
Monthly plan premium
$54 for Standard plan with Part D
$142 for High plan with Part D
Value plan with Part D
$0 for residents of Virginia
Standard plan with Part D
$25 for residents of Virginia
High plan with Part D
$142 for residents of Virginia
Maximum out-of-pocket amount
Standard plan with Part D
$6,700
High plan with Part D
$5,000
Value plan with Part D
$6,700
Standard plan with Part D
$6,700
High plan with Part D
$5,500
Doctor office visits
Standard plan with Part D
Primary care visits:
$10 per visit
Specialist visits:
$45 per visit
High plan with Part D
Primary care visits:
$5 per visit
Specialist visits:
$30 per visit
Value plan with Part D
Primary care visits:
$15 per visit
Specialist visits:
$45 per visit
Standard plan with Part D
Primary care visits:
$5 per visit
Specialist visits:
$35 per visit
High plan with Part D
Primary care visits:
$5 per visit
Specialist visits:
$30 per visit
Inpatient hospital stays
Standard plan with Part D
$850 per benefit period
High plan with Part D
$350 per benefit period
Value plan with Part D
You pay $275 a day for days 1-5; no charge for the remainder of your stay.
Standard plan with Part D
You pay $250 a day for days 1-5; no charge for the remainder of your stay.
High plan with Part D
You pay $200 a day for days 1-5; no charge for the remainder of your stay.
Silver&Fit3 gym membership and at-home fitness program
Included
Included for Standard and High plans.
Not available for Value plan.
Advantage Plus enhanced dental, hearing, and vision benefits
Available for a monthly $25 fee
Available for a monthly $25 fee
Part D prescription drug coverage
Preferred cost-sharing during the initial coverage stage (up to a 30-day supply):
Standard plan with Part D
Drug Tier 1:
$7
Drug Tier 2:
$15
High plan with Part D
Drug Tier 1:
$2
Drug Tier 2:
$15
Value plan with Part D
Drug Tier 1:
$5
Drug Tier 2:
$15
Standard plan with Part D
Drug Tier 1:
$3
Drug Tier 2:
$12
High plan with Part D
Drug Tier 1:
$5
Drug Tier 2:
$15
Plans for DC
BENEFIT
2020 Medicare Plus (COST) Plan
2020 Medicare Advantage (HMO) Plan
Physician options
To receive benefits of the Kaiser Permanente Medicare Plus (Cost) plan, you must use Mid-Atlantic Permanente Medical Group physicians and affiliates.
You may go to any other provider who accepts Medicare and receive Original Medicare benefits.
To receive benefits of the Kaiser Permanente Medicare Advantage plan, you must use Mid-Atlantic Permanente Medical Group physicians and affiliates.
No benefits for other providers.
NOTE: If you are already scheduled for treatment after January 1, 2020 with a provider who is not part of the Kaiser Permanente Medicare Advantage network, please download and fill out the Continuity of Care Form in Helpful Documents and contact Member Services at 1-888-777-5536 (TTY 711), Monday through Friday, 8 a.m. to 8 p.m. so we can determine if you are eligible to temporarily continue care with that provider.
Network hospitals in the District of Columbia, Maryland, and Virginia
13
18
Monthly plan premium
$54 for Standard plan with Part D
$142 for High plan with Part D
Value plan with Part D
$0 for residents of Virginia
Standard plan with Part D
$25 for residents of Virginia
High plan with Part D
$142 for residents of Virginia
Maximum out-of-pocket amount
Standard plan with Part D
$6,700
High plan with Part D
$5,000
Value plan with Part D
$6,700
Standard plan with Part D
$6,700
High plan with Part D
$5,500
Doctor office visits
Standard plan with Part D
Primary care visits:
$10 per visit
Specialist visits:
$45 per visit
High plan with Part D
Primary care visits:
$5 per visit
Specialist visits:
$30 per visit
Value plan with Part D
Primary care visits:
$15 per visit
Specialist visits:
$45 per visit
Standard plan with Part D
Primary care visits:
$5 per visit
Specialist visits:
$35 per visit
High plan with Part D
Primary care visits:
$5 per visit
Specialist visits:
$30 per visit
Inpatient hospital stays
Standard plan with Part D
$850 per benefit period
High plan with Part D
$350 per benefit period
Value plan with Part D
You pay $275 a day for days 1-5; no charge for the remainder of your stay.
Standard plan with Part D
You pay $250 a day for days 1-5; no charge for the remainder of your stay.
High plan with Part D
You pay $200 a day for days 1-5; no charge for the remainder of your stay.
Silver&Fit3 gym membership and at-home fitness program
Included
Included for Standard and High plans.
Not available for Value plan.
Advantage Plus enhanced dental, hearing, and vision benefits
Available for a monthly $25 fee
Available for a monthly $25 fee
Part D prescription drug coverage
Preferred cost-sharing during the initial coverage stage (up to a 30-day supply):
Standard plan with Part D
Drug Tier 1:
$7
Drug Tier 2:
$15
High plan with Part D
Drug Tier 1:
$2
Drug Tier 2:
$15
Value plan with Part D
Drug Tier 1:
$5
Drug Tier 2:
$15
Standard plan with Part D
Drug Tier 1:
$3
Drug Tier 2:
$12
High plan with Part D
Drug Tier 1:
$5
Drug Tier 2:
$15
Ready to get started?
Call us at 1-877-218-9489 (TTY 711) or schedule a Personal Appointment, and we’ll walk you through your options. Our friendly representatives are available, 7 days a week, 8 a.m. to 8 p.m. Hablamos español.
Enroll now
Connect with a Kaiser Permanente Medicare specialist in your area.
Call to enroll
Call 1-877-218-9489 (TTY 711) to speak with a Kaiser Permanente Medicare Specialist.
Attend a seminar
Find a seminar in your area to learn more about our Kaiser Permanente Medicare health plans.
Ready to enroll?
Set up a personal appointment
Connect with a licensed Kaiser Permanente Medicare Specialist in your area, on your schedule. Simply complete the form (click or tap to open) and we'll contact you to set up an appointment.
Connect now
Call to enroll
Call 1-877-218-9489 (TTY 711) to speak with a Kaiser Permanente Medicare Specialist, 7AM-7PM M-F. They will walk you through your options and get you signed up right over the phone.
Attend a seminar
Find a seminar in your area to learn more about our Kaiser Permanente Medicare health plans.
Enroll online
Enrolling in our Medicare Advantage Plans online is simple. Click or tap to be taken to our enrollment site, answer a few questions, and you're done.
Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. 2101 E. Jefferson St., Rockville, MD 20852
Kaiser Permanente is an HMO plan with a Medicare contract. Enrollment in Kaiser Permanente depends on contract renewal. You must reside in the Kaiser Permanente Medicare health plan service area in which you enroll.
For accommodations of persons with special needs at meetings, call 1-877-218-9489 (TTY 711).
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© 2020-2021 Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.
Page last updated on March 15, 2021