The bottom line: Kaiser Permanente’s quality ratings from the Centers for Medicare & Medicaid Services (CMS) are above average, and its average maximum out-of-pocket is lower than all major companies. If you live in one of the nine states or Washington, D.C., where plans are offered and don't mind a Medicare Advantage HMO plan, Kaiser is a strong contender. Jump to: Full Review
Kaiser Permanente Medicare Advantage pros and cons
Pros
- Californians are happy: Kaiser got the highest score in terms of customer satisfaction in California, one of the major Medicare markets measured by JD Power in this year's study.
- Government quality ratings: Kaiser’s quality ratings from CMS are well above average.
Cons
- Limited availability: Kaiser Permanente plans are available in just nine states and Washington, D.C.
- 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 most major companies.
Compare against other providers
🔍 UnitedHealthcare Medicare Advantage
» More options in our roundup of the best Medicare Advantage plans
Compare against other providers
🔍 UnitedHealthcare Medicare Advantage
» More options in our roundup of the best Medicare Advantage plans
Our full review
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NerdWallet star rating for Kaiser Permanente Medicare Advantage
Kaiser Permanente Medicare Advantage plans earned 4.2 out of 5 stars for overall performance. NerdWallet’s ratings are determined by our editorial team. The scoring formula takes into account premiums, out-of-pocket costs, government quality ratings, customer complaints, disenrollment survey data, third party quality accreditation and more.
NerdWallet star ratings are different from CMS ratings for Medicare plans.
Our data-driven, consumer-first scoring rubric for Medicare Advantage plans includes crucial metrics like cost and a wider range of data sources for quality and customer satisfaction in addition to the information incorporated into CMS ratings.
Government quality ratings for Kaiser Permanente Medicare Advantage
Average CMS star rating, weighted by enrollment: 4.41
Kaiser Permanente Medicare Advantage plans are rated well above the industry average, receiving an average rating of 4.41 stars out of 5 from the Centers for Medicare & Medicaid Services (CMS) for 2026, weighted by enrollment. For comparison, the average weighted CMS star rating for plans from all companies is 4.02.
100% of Kaiser Permanente Medicare Advantage members are in plans rated 4 stars or better for 2026.
CMS maintains its own database of 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.
All Medicare Advantage plans are evaluated on health plan measures, and Medicare Advantage plans that include prescription drug coverage are also evaluated on drug plan measures.
You can find a plan’s rating with Medicare's plan finding tool.
How much does Kaiser Permanente Medicare Advantage cost?
Premiums
About 54% of Kaiser Permanente Medicare Advantage plans have a $0 premium.
Kaiser Permanente plans with a monthly premium cost about $66.40 per month on average, weighted by enrollment. That’s pricier than average among the Medicare Advantage companies NerdWallet reviews.
With any Medicare Advantage plan, you'll also be responsible for paying your Medicare Part B premium, which is $202.90 per month in 2026.
Most people pay this standard Part B amount, but if your income is above a certain threshold, you'll pay the income-related monthly adjustment amount (IRMAA). Some Medicare Advantage plans cover part or all of your Part B premium.
Prescription drugs
About 96% of Kaiser Permanente (KP) Medicare Advantage plans include prescription drug coverage.
Here's what you might pay for prescription drugs at some common price points.
Tier 1 (Preferred generics) 86.3% of KP Medicare Advantage plans have $0 copays/coinsurance.
$3.08: Average out-of-pocket cost for a drug with a $15 retail price, among KP plans with copays or coinsurance at Tier 1 (after deductible, if any).
Tier 2 (Most generics) 27.5% of KP Medicare Advantage plans have $0 copays/coinsurance.
$7.67: Average out-of-pocket cost for a drug with a $50 retail price, among KP plans with copays or coinsurance at Tier 2 (after deductible, if any).
Tier 3 (Preferred brands) 8.6% of KP Medicare Advantage plans have $0 copays/coinsurance.
$45.07: Average out-of-pocket cost for a drug with a $200 retail price, among KP plans with copays or coinsurance at Tier 3 (after deductible, if any).
Other out-of-pocket costs
Kaiser Permanente Medicare Advantage plans have an average maximum out-of-pocket (MOOP) spending cap of $4,133, weighted by enrollment. That’s well below the average among the companies NerdWallet reviews.
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 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 whether the plan charges for them.
To get a sense of costs, Medicare.gov and most other Medicare shopping tools can help you compare plans' premiums and out-of-pocket costs for certain services and prescription drugs in your location.
Why do people leave Kaiser Permanente Medicare Advantage plans?
CMS surveys people who voluntarily leave their Medicare plans about their reasons for leaving. Here’s the breakdown of problems people identified with their former Kaiser Permanente Medicare plans.
Problems getting covered care: 20% (All-company average: 11%).
Problems with doctor/hospital networks: 19% (All-company average: 17%).
Financial issues: 16% (All-company average: 17%).
Problems with prescription drug benefits: 7% (All-company average: 3%).
Problems getting information from the plan: 15% (All-company average: 9%).
(Members can give more than one reason for leaving on the survey and might leave plans for other reasons, so the categories won’t add up to 100%.)
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 of Kaiser Permanente
Fitch Ratings Insurer Financial Strength: AA- (stable)
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 2025, Fitch Ratings affirmed an Insurer Financial Strength rating of AA- (stable) for Kaiser Foundation Health Plan and its insurance company subsidiaries (KFHP collectively). Among other factors, Fitch Ratings called out KFHP’s favorable competitive positioning, unique operating model, and strong financial performance and earnings.
JD Power Ranking
JD Power releases an annual study measuring member satisfaction with Medicare Advantage plans. It uses eight factors, such as level of trust, ability to get health services, ease of doing business and resolving problems or complaints.
Kaiser Permanente placed first among all companies on the survey in California (the only state where Kaiser had enough market share to be considered).
NCQA accreditation: 89% of plans
About 89% of Kaiser Permanente Medicare Advantage plans are NCQA accredited as of the most recent annual update in September 2025.
The National Committee for Quality Assurance (NCQA) evaluates health insurance plans based on clinical measures and customer experience survey results. To earn NCQA accreditation, plans need to meet standards related to quality, population health management, provider networks, member experience and more.
Kaiser Permanente Medicare Advantage service area
Kaiser Permanente offers Medicare Advantage plans in nine states and Washington, D.C. The company has plans in California, Colorado, Georgia, Hawaii, Maryland, Nevada, Oregon, Virginia, Washington, D.C. and Washington state.
(Kaiser Permanente recently entered Nevada as a co-owner of Hometown Health/Senior Care Plus plans, which will become Kaiser Permanente Nevada plans after a transition period in 2026.)
Over 2 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 12.6 million people. 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.
Kaiser Permanente Medicare Advantage customer service
Kaiser Permanente Medicare Advantage members can contact their plan’s customer service in a few ways:
Call 888-777-5536 (TTY: 711), available daily from 8 a.m. to 8 p.m.
Chat with a member services representative after signing into your account.
Compare Medicare Advantage companies
Get more information below about some of the major Medicare Advantage insurance companies. 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 preferred medical 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).
- Earns top customer satisfaction scores in California, one of the major Medicare markets studied by JD Power.
- Quality ratings from CMS are well above average.
- Available in only nine states and Washington, D.C.
- Offers mostly HMO plans, so most members must work within Kaiser’s network of medical providers.
- Member experience ratings are below average.
NerdWallet writers are subject matter authorities who use primary, trustworthy sources to inform their work, including peer-reviewed studies, government websites, academic research and interviews with industry experts. All content is fact-checked for accuracy, timeliness and relevance. You can learn more about NerdWallet's high standards for journalism by reading our editorial guidelines.
- 1.NerdWallet analysis of CMS data. 2026 Star Ratings Data Tables. Accessed Apr 23, 2026.
- 2.NerdWallet analysis of CMS data. Monthly Enrollment by Plan. Accessed Apr 23, 2026.
- 3.NerdWallet analysis of CMS data. CY2026 Landscape 202603. Accessed Apr 23, 2026.
- 4.Centers for Medicare & Medicaid Services. Understanding Medicare Advantage Plans. Accessed Apr 23, 2026.
- 5.NerdWallet analysis of CMS data. Beneficiary Cost File. Accessed Apr 23, 2026.
- 6.NerdWallet analysis of CMS data. 2026 Star Ratings Data Table - Disenrollment Reasons (Oct 8 2025). Accessed Apr 23, 2026.
- 7.Fitch Ratings. Fitch Affirms Kaiser Foundation Health Plan's 'AA-' IFS Rating; Outlook Stable. Accessed Apr 23, 2026.
- 8.JD Power. Medicare Advantage Plan Member Satisfaction Facing Headwinds; Digital Innovation an Emerging New Solution, JD Power Finds. Accessed Apr 23, 2026.
- 9.NCQA. Health Plans. Accessed Apr 23, 2026.
- 10.Hometown Health. Kaiser Permanente Launches in Nevada in 2026. Accessed Apr 23, 2026.
Medicare Advantage review methodology
NerdWallet’s Medicare Advantage ratings are based on premiums, out-of-pocket costs, prescription drug coverage, quality data from the Centers for Medicare & Medicaid Services, consumer experience and more. We calculate each health insurance company’s rating on a curved 5-point scale.
NerdWallet’s editorial team analyzed companies covering about 87% of all Medicare Advantage beneficiaries in the United States. We reviewed 25 Medicare Advantage brands, with some insurance companies having more than one brand under their umbrella. (For example, Blue Cross Blue Shield includes the brands Anthem and Highmark.)
The Medicare Advantage marketplace is concentrated among just a handful of companies. In many places, one company serves more than half of the market. At the national level, NerdWallet’s reviews include each of the 10 largest brands by enrollment.
At the state level, our research includes at least one major insurer in every state where Medicare Advantage plans are sold, and includes the top two insurers in 40 of those 49 states. (Alaska doesn't offer Medicare Advantage plans.) We also look at online search volume to identify regional and other notable players in the space.
These reviews are a guide, but we encourage you to shop around and compare several plans to find the best coverage and rate for you. NerdWallet does not receive compensation for any reviews. Read our editorial guidelines for additional information.
Compare Medicare Advantage plans
Insurance company | CMS star rating | States available | Members in high-rated plans | Member experience | Learn more | |
|---|---|---|---|---|---|---|
(855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet | 4.11 | 4.11/5 | 48 states and Washington, D.C. | Medium (50% to 84%) | 3.74 (Above average) | (855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet |
(855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet | 3.79 | 3.79/5 | 46 states and Washington, D.C. | Low (49% or less) | 3.82 (Above average) | (855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet |
(855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on http://askchapter.org on NerdWallet | 4.20 | 4.20/5 | 43 states and Washington, D.C. | Medium (50% to 84%) | 3.89 (Above average) | (855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on http://askchapter.org on NerdWallet |
(855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet | 3.76 | 3.76/5 | 29 states and Washington, D.C. | Medium (50% to 84%) | 3.96 (Above average) | (855) 432-0512 / TTY 711 M-F 9AM-9PM, Sat 10AM-6PM ETSpeak to a licensed insurance agent on askchapter.orgon NerdWallet |