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|
Monthly premium |
$0 |
|
Annual deductible |
None |
|
Doctor office visits |
$10 Primary $35 Specialist |
|
Emergency care We cover emergency care anywhere in the world. |
$95 per emergency department visit |
|
Urgently needed services We cover urgent care anywhere in the world. |
$35 per office visit |
|
Preventive services1 |
No charge |
|
Inpatient hospitalization |
$225 per day for days 1 through 5 No charge for the remainder of your stay |
|
Outpatient surgery |
$200 |
|
Skilled nursing facility Up to 100 days per benefit period |
$0 per day for days 1 through 20 $196 per day for days 21 through 100 |
|
Lab, X-ray |
$0 Lab $10 X-ray |
|
MRI, CT, and PET |
$100 |
|
Physical therapy |
$35 per visit |
|
Ambulance service Per one-way trip |
$250 |
|
Fitness program Silver&Fit®9 |
No cost for membership to any of the participating facilities, exercise programs, and digital fitness and well-being choices. |
|
Over-the-counter (OTC) wellness credit6 Quarterly allowance to purchase items such as cold remedies, antacids, pain relievers, etc. |
$30 quarterly allowance |
|
Annual maximum out-of-pocket |
$6,900 |
|
NEW: Comprehensive dental plan11
The comprehensive dental plan also include a $1,000 annual allowance with a 50% coinsurance for more extensive care, such as fillings, crowns, dentures, root canals, and more. |
$0 copay per visit |
|
Hearing aids7 |
$1,000 allowance per ear every 36 months through Kaiser Permanente audiology centers |
Enhance your health and well–being by combining the affordable benefits of Advantage Plus with your Kaiser Permanente Medicare Advantage (HMO) plan.
Only $20 a month added to your Medicare Advantage premium gets you Advantage Plus coverage. You’ll get these benefits:
ADVANTAGE PLUS(optional supplemental package) premium and benefits |
YOU PAY |
|---|---|
Monthly premium in addition to monthly Medicare Advantage individual plan premium and monthly Medicare premium(s) |
$20 |
Comprehensive dental services6
|
$500 annual allowance towards comprehensive dental services with a 50% coinsurance for a total of $1,500 when added together with the preventive dental benefit included in your Kaiser Permanente Medicare Advantage plan |
Hearing aids |
$1,000 allowance per ear every 3 years for a total of $2,000 per ear every 3 years when added together with the hearing aid benefit included in your Kaiser Permanente Medicare Advantage plan |
Eyeglasses and contact lenses |
$175 allowance per eyewear every 2 years which can be combined with the eyewear allowance included in your Kaiser Permanente Medicare Advantage plan. To see your vision allowance, please refer to your Evidence of Coverage. |
If you’re already a member of a Kaiser Permanente Medicare Advantage plan, you can add Advantage Plus anytime from October 15, 2022, through March 31, 2023. Your Advantage Plus coverage will start:
1 Every year, Medicare evaluates plans based on a 5-star rating system.
2 $0 copay for all preventive services covered under Original Medicare at zero cost sharing.
3 The physicians who practice at Kaiser Permanente are recognized as Top Doctors in Northern Virginia Magazine (2023), Washingtonian magazine (2022), and Baltimore magazine (2022).
4 If you travel out of state, phone appointments and video visits may not be available due to state laws that may prevent doctors and health care providers from providing care across state lines. Laws differ by state.
5 With 50% coinsurance.
6 Please refer to your Evidence of Coverage for details. OTC benefits may change each year on January 1. Each order must be at least $20. Any unused portion of the quarterly benefit limit will not carry forward to the next quarter. Your order may not exceed your quarterly benefit limit. Limitations and restrictions may apply. Cash, check, credits cards, or money orders are not accepted.
7 Hearing aid allowance can only be used for hearing aids purchased at Kaiser Permanente audiology centers.
8 Twenty-four one-way rides per contract year. For nonemergency transportation only.
9 Not available with Kaiser Permanente Medicare Advantage Value Balt, Kaiser Permanente Medicare Advantage Value MD, or Kaiser Permanente Medicare Advantage Value DC plans. The Silver&Fit program is provided by American Specialty Health Fitness, Inc. (ASH Fitness), a subsidiary of American Specialty Health Incorporated (ASH). Silver&Fit is a registered trademark of ASH and used with permission herein. All programs and services are not available in all areas. Participating fitness centers and fitness chains may vary by location and are subject to change.
10 Free with no obligation.
11 Dental benefits are underwritten by Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc., and administered by Dominion National. To find an in-network dentist, call 1-855-733-7524 or visit DominionNational.com/kaiserdentists.
For more information about benefits, please view the 2023 Summary of Benefits
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.
Kaiser Permanente is an HMO and HMO-POS 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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Page last updated on March 17, 2023 at 9 a.m. EST
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