Kaiser Permanente Medicare Advantage 2024 Review

Kaiser Permanente’s Medicare Advantage plans get average ratings and are available in only a handful of states.
Alex Rosenberg
Kate Ashford, CSA®
By Kate Ashford, CSA® and  Alex Rosenberg 
Updated
Edited by Holly Carey

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Kaiser Permanente Medicare Advantage - ME

Kaiser Permanente

3.94

CMS Star Rating

Kaiser Permanente plans get average star ratings — lower than last year — and the provider sells plans in only eight states and Washington, D.C.

(888) 614-3549 / TTY 711

8am - 11pm EST, 7 days a week

Speak to a licensed insurance agent on MedicareEnrollment.com

GET A QUOTE

from MedicareEnrollment.com

States available

8 states and Washington, D.C.


Members in high-rated plans

Medium (50% to 89%)


Member experience

2.44 (Below average)


States available

8 states and Washington, D.C.


Members in high-rated plans

Medium (50% to 89%)


Member experience

2.44 (Below average)


Pros

  • Earns above-average customer satisfaction scores in California, one of the major Medicare markets studied by J.D. Power.
  • Eight in 10 members are in a highly-rated plan.
  • Most plans include drug coverage.

Cons

  • Available in only eight states and Washington, D.C.
  • Offers mostly HMO plans, so most members must work within Kaiser’s network of medical providers.
  • Member experience ratings overall are below average.

Kaiser Permanente is the fifth-largest provider of Medicare Advantage plans

, and the insurer's 2024 plans score just below the industry average in terms of Medicare star ratings — a drop from 2023 plans.

It’s also the largest not-for-profit health care organization in the United States. Kaiser uses an integrated care model, which means that members can get all their care in one place and all the providers are connected

Kaiser Permanente. Our Model. Accessed Oct 23, 2023.
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Kaiser's plans are available in only eight states and Washington, D.C., and the company offers mostly HMO plans — which are less flexible than other options. Here’s what you should know about Kaiser Permanente Medicare Advantage.

Kaiser Permanente Medicare Advantage pros and cons

Kaiser Permanente’s offerings have advantages and disadvantages.

Pros

  • Californians are happy: Kaiser plans score above the industry average in terms of customer satisfaction in California, one of the major Medicare markets measured by J.D. Power in this year's study.

  • Members are in strong plans: Eight out of 10 Kaiser Medicare Advantage members (81%) are in a plan rated 4 stars or higher.

  • Prescription benefits: Most of Kaiser’s Medicare Advantage plans include drug coverage.

Cons

  • Limited availability: Kaiser Permanente plans are available in just eight states and Washington, D.C. (Kaiser sells plans in California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia and Washington state.)

  • Limited plan types: Kaiser offers mostly HMO plans, so most members must work within Kaiser’s network of medical providers.

  • Low member experience ratings: Kaiser’s member experience ratings, including customer service and getting needed care, are lower than other major providers.

Kaiser Permanente Medicare star ratings

Average star rating, weighted by enrollment: 3.94

If you want Medicare’s take on Kaiser Permanente’s plans, look no further than the Centers for Medicare & Medicaid Services' own star ratings, which rank each plan from best (5 stars) to worst (1 star). The agency bases these ratings on plans’ quality of care and measurements of customer satisfaction, and ratings may change from year to year.

Based on the most recent year of data and weighted by enrollment, Kaiser Permanente’s 2024 Medicare Advantage plans scored 3.94 stars

Centers for Medicare & Medicaid Services. 2024 Star Ratings Data Tables (Oct 13 2023) (ZIP). Accessed Oct 23, 2023.
.

For comparison, the average star rating for plans from all providers was 4.04

Centers for Medicare & Medicaid Services. 10.13.23 Fact Sheet - 2024 Medicare Advantage and Part D Ratings (PDF). Accessed Oct 23, 2023.
.

You can find a plan’s rating with the Medicare plan finding tool.

What does Kaiser Permanente Medicare Advantage cost?

Costs for Medicare Advantage plans will depend on your plan, your location and your health needs.

Premiums

One of the costs to consider is the plan’s premium, and half of Kaiser Permanente’s Medicare Advantage plans are $0-premium plans in 2024

Centers for Medicare & Medicaid Services. CY2024_Landscape_Files_Final_20231005 (ZIP). Accessed Oct 23, 2023.
.

Even as a Medicare Advantage user, you’ll still be responsible for paying your Medicare Part B premium, which is $174.70 per month in 2024. However, some plans cover part or all of this cost

Centers for Medicare & Medicaid Services. Understanding Medicare Advantage Plans. Accessed Oct 23, 2023.
.

Copays, coinsurance and deductibles

Requirements for copays, coinsurance and deductibles vary depending on your plan, location and the services you use. Other out-of-pocket costs to consider include:

  • Whether the plan covers any part of your monthly Medicare Part B premium.

  • The plan’s yearly deductibles and any other deductibles, such as a drug deductible.

  • Copayments and/or coinsurance for each visit or service. For instance, there may be a $10 copay for seeing your primary doctor and a $45 copay for seeing a specialist.

  • The plan’s in-network and out-of-network out-of-pocket maximums.

  • Whether your medical providers are in-network or out-of-network, or how often you may go out of network for care.

  • Whether you require extra benefits, and if the plan charges for them.

Here are examples of Kaiser Permanente Medicare Advantage costs for the most popular plans in a mid-range city:

Kaiser Permanente Medicare Advantage plan

Pricing

Kaiser Permanente Medicare Advantage Centennial (HMO)

Monthly premium: $0.

Out-of-pocket max: $4,950.

Copays:

  • Primary care: $0.

  • Specialist: $25.

  • Tier 1 prescription drugs: $2.

Kaiser Permanente Medicare Advantage Basic (HMO)

Monthly premium: $76.

Out-of-pocket max: $4,200.

Copays:

  • Primary care: $0.

  • Specialist: $30.

  • Tier 1 prescription drugs: N/A.

Kaiser Permanente Medicare Advantage Columbia (HMO)

Monthly premium: $64.

Out-of-pocket max: $3,950.

Copays:

  • Primary care: $0.

  • Specialist: $25.

  • Tier 1 prescription drugs: $2.

Selected plans are available in ZIP code 99201.

To get a sense of costs, use Medicare’s website to compare information among available plans in your area. You can select by insurance carrier to see only Kaiser Permanente plans or compare across carriers. You can also shop directly from Kaiser Permanente’s website by entering your ZIP code.

Kaiser Permanente Medicare Advantage plan types

Kaiser Permanente offers mostly HMO Medicare Advantage plans, but also offers some PPO plans.

Plan availability may vary by county. Plan offerings may include the following types:

A health maintenance organization (HMO) generally requires that you use a specific network of doctors and hospitals. You may need a referral from your primary doctor in order to see a specialist, and out-of-network benefits are usually very limited.

HMO point-of-service plans are HMO plans that allow members to get some out-of-network services, but you’ll pay more for those services.

Preferred provider organization (PPO) plans provide the most freedom, allowing you to see any provider that accepts the insurance. You may not need to choose a primary doctor, and you don’t need referrals to see specialists. You can seek out-of-network care, although it may cost more than seeing an in-network doctor.

Special needs plans (SNPs) restrict membership to people with certain diseases or characteristics. Hence, the benefits, network and drug formularies are tailored to the needs of those members. Kaiser Permanente offers one type of SNP:

  • Dual-Eligible SNP: For people who are entitled to Medicare and who also qualify for assistance from a state Medicaid program.

Third-party ratings

There are a few companies that weigh in on health plans or on the strength of the company in question, and we’ve included three here:

Fitch Ratings Insurer Financial Strength: AA- (very strong)

Fitch Ratings is a credit rating agency that assigns ratings based on its opinion of a company’s ability to meet financial commitments. In June 2023, Fitch Ratings affirmed an Insurer Financial Strength rating of AA- (very strong) for Kaiser Foundation Health Plan, or KFHP, and its insurance company subsidiaries. Among other factors, Fitch Ratings called out KFHP’s favorable competitive positioning, unique operating model, and strong financial performance and earnings

.

J.D. Power Ranking

In its 2023 Medicare Advantage Study — the ninth it's done so far — J.D. Power measured member satisfaction with Medicare Advantage plans based on eight factors ranging from level of trust to how well a provider resolves problems or complaints. The study was fielded in the five biggest Medicare markets: California, Florida, New York, Pennsylvania and Texas. On these measures, Kaiser Foundation Health Plan placed third of all major providers in California (the only state of the five in which Kaiser has plans)

.

NCQA Score Range: 4.5 out of 5

The National Committee for Quality Assurance rates health insurance plans on a 5-point scale (with 5 being best) based on quality of care, patient satisfaction and health plans’ efforts to keep improving.

In its September 2023 ratings of Kaiser Permanente plans, the NCQA awarded ratings of 4.5 to all Kaiser plans listed

NCQA. Health Plans. Accessed Oct 23, 2023.
.

Kaiser Permanente Medicare Advantage service area

Kaiser Permanente offers Medicare Advantage plans in eight states and Washington, D.C.

More than 1.8 million Medicare beneficiaries are enrolled in Kaiser Permanente Medicare Advantage plans.

About Kaiser Permanente

Kaiser Permanente, headquartered in Oakland, California, was founded in 1945 and serves 12.7 million people across eight states and Washington, D.C. The company is made up of Kaiser Foundation Health Plan, Kaiser Foundation Hospitals and its subsidiaries, and the Permanente Medical Groups.

Kaiser Permanente offers insurance for individuals and families, employer group plans, Medicaid/Medi-Cal and Medicare Advantage.

Customer service

Kaiser Permanente Medicare Advantage members can contact their plan’s customer service in a few ways:

  • Call a customer service representative, available daily from 8 a.m. to 8 p.m. The phone number varies by location. Find yours by clicking on “Support Center” under “Member Support” at the bottom of your plan’s website.

  • Chat with a member services representative after signing into your account.

  • Send an email with non-urgent questions or comments.

Compare Medicare Advantage providers

Get more information below about some of the major Medicare Advantage providers. These insurers offer plans in most states. The plans you can choose from will depend on your ZIP code and county.

Find the right Medicare Advantage plan

It’s important to do your research before selecting a Medicare Advantage plan for yourself. Here are some questions to consider asking:

  • What are the plan’s costs? Do you understand what the plan’s premium, deductibles, copays and/or coinsurance will be? Can you afford them?

  • Is your doctor in-network? If you have a preferred medical provider or providers, make sure they participate in the plan’s network.

  • Are your prescriptions covered? If you’re on medication, it’s crucial to understand how the plan covers it. What tier are your prescription drugs on, and are there any coverage rules that apply to them?

  • Is there dental coverage? Does the plan offer routine coverage for vision, dental and hearing needs?

  • Are there extras? Does the plan offer any extra benefits, such as fitness memberships, transportation benefits or meal delivery?

If you have additional questions about Medicare, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).

Still deciding on the right carrier? Compare Medicare Advantage plans

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