Kaiser Permanente vs. Anthem: Medicare Advantage Comparison

Kaiser Permanente’s star ratings are higher than Anthem’s, but member experience scores are low for both.
Kate Ashford, CSA®
By Kate Ashford, CSA® 
Updated
Edited by Holly Carey

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Kaiser Permanente Medicare Advantage plans are available in only eight states and Washington, D.C., while Anthem-branded plans are available in 14 states. While Kaiser Permanente’s average star ratings from the Centers for Medicare & Medicaid Services (CMS) are higher than those from Anthem, neither company is above the industry average. Member experience scores from CMS for both Kaiser Permanente and Anthem are lower than most major providers.

Here’s a look at how Kaiser Permanente and Anthem compare.

Kaiser Permanente Medicare Advantage

Kaiser Permanente Medicare Advantage

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.

M-F 9am-9pm ET, Sa 10am-9pm ET

Speak to a licensed insurance agent on askchapter.org

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from askchapter.org

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.

Other factors to consider

Provider size

5th-largest provider of Medicare Advantage plans.

Medicare Advantage enrollment

1.8 million.

Percent of plans rated 4 stars or higher

33%.

Percent of plans with $0 premium

51%.

Plans available

HMO, HMO-POS, PPO, SNP.

Anthem Medicare Advantage

Anthem Medicare Advantage

Anthem

3.45

CMS Star Rating

Anthem's plans offer a range of benefits and flexible care, but plans are available in only 14 states and receive below-average star ratings.

M-F 9am-9pm ET, Sa 10am-9pm ET

Speak to a licensed insurance agent on askchapter.org

GET A QUOTE

from askchapter.org

States available

14 states


Members in high-rated plans

Low (49% or less)


Member experience

2.89 (Below average)


States available

14 states


Members in high-rated plans

Low (49% or less)


Member experience

2.89 (Below average)


Pros

  • Most plans cover prescription drugs and offer some coverage for dental, hearing and vision care.
  • Anthem's "Essential Extras" benefits let members choose extra plan benefits that meet their needs, such as $500/year toward assistive devices or $150/quarter toward household utilities.

Cons

  • Available in only 14 states.
  • Below-average overall star rating and member experience scores from CMS.
  • 4-star rated plans available in only three states.

Other factors to consider

Provider size

Part of the Blue Cross Blue Shield collective, which is the 3rd-largest provider of Medicare Advantage plans.

Medicare Advantage enrollment

More than 1.3 million.

Percent of plans rated 4 stars or higher

5%.

Percent of plans with $0 premium

59%.

Plans available

HMO, HMO-POS, PPO, SNP.

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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