Kaiser Medicare Advantage Plans 2025: Costs, Coverage & Ratings Across 9 States
Explore Kaiser Permanente's top-rated Medicare Advantage plans available in 2025 across nine states. Discover costs, coverage options including dental and vision, eligibility, and how these 5-star plans can benefit you.
Kaiser Permanente provides a range of Medicare Advantage plans, including the Advantage Plus supplement plan that offers dental, vision, and hearing benefits in multiple regions throughout the United States.
Operating since 1945, Kaiser Permanente is renowned for its unique healthcare model emphasizing quality and efficiency. Many of its Medicare Advantage plans proudly hold a 5-star rating, the highest Medicare rating available.
Kaiser’s offerings primarily include Health Maintenance Organization (HMO) plans, with additional options such as Preferred Provider Organization (PPO) and standalone prescription drug plans.
Continue reading to learn about the variety of Medicare Advantage plans Kaiser offers and the states where these plans are accessible.
Types of Medicare Advantage Plans Kaiser Offers
Kaiser’s Medicare Advantage options vary by plan and location, but typically include the following:
Kaiser HMO Plans
These plans require members to select an in-network primary care physician for all preventive and ongoing care. Referrals from your primary doctor are needed to see specialists. Kaiser’s HMO plans often include extra benefits like SilverSneakers fitness memberships and prescription drug coverage with convenient mail-order pharmacy options.
Kaiser PPO Plans
With PPO plans, members can visit any licensed provider but benefit from lower costs when choosing participating providers. Referrals are not required for specialists, though pre-certification is needed for certain procedures such as outpatient surgeries and advanced lab work.
Kaiser Part D Prescription Drug Plans
Separate from Medicare Advantage, Kaiser offers standalone Part D plans featuring tiered formularies to help manage medication costs. Using Kaiser pharmacies or mail-order services can maximize savings.
Kaiser Special Needs Plans (SNPs)
Specialized plans cater to individuals with specific healthcare needs, including:
- Chronic Condition SNPs for ongoing health issues
- Institutional SNPs for long-term care residents
- Dual Eligible SNPs for those qualifying for both Medicare and Medicaid
States Where Kaiser Medicare Advantage Plans Are Available
Kaiser’s Medicare Advantage plans are currently offered in these nine states and Washington D.C.:
- California
- Colorado
- Georgia
- Hawaii
- Maryland
- Oregon
- Virginia
- Washington
- Washington D.C.
Coverage Highlights of Kaiser Medicare Advantage Plans
Coverage varies by plan and location but generally includes:
- All benefits of Original Medicare (Parts A & B), including hospital and medical services
- Preventive care such as blood pressure, cholesterol, and cancer screenings often at no or low cost
- Basic hearing and vision exams annually, with additional benefits like hearing aids and eyewear available through Advantage Plus plans
Many plans also include access to wellness programs like SilverSneakers to support a healthy lifestyle.
2025 Kaiser Medicare Advantage Plan Costs by City
Use Medicare.gov’s plan finder to check availability and pricing in your area. Below are sample 2025 costs for popular Kaiser plans in select cities:
| City / Plan | Star Rating | Monthly Premium (with Drug Coverage) | Health & Drug Deductibles | Out-of-Pocket Max | Primary Care Copay | Specialist Copay |
|---|---|---|---|---|---|---|
| Atlanta, GA: Kaiser Senior Advantage Enhanced 1 (HMO) | 4.5 | $67 | $0, $0 | $4,900 | $0 | $0-$15 |
| Denver, CO: Kaiser Senior Advantage Core DM (HMO) | 4 | $0 | $0, $0 | $3,300 | $0 | $15 |
| Honolulu, HI: Kaiser Senior Advantage Basic (HMO) | 4.5 | $20 | $0, $0 | $7,550 | $15 | $45 |
| Portland, OR: Kaiser Senior Advantage Value (HMO) | 4 | $0 | $0, $0 | $5,000 | $0 | $35 |
| Washington, D.C.: Kaiser Medicare Advantage Standard DC (HMO) | 4.5 | $30 | $0, $0 | $6,900 | $5 | $0-$35 |
Note: These premiums exclude the standard Medicare Part B premium, which is paid separately.
Understanding Medicare Advantage (Part C)
Medicare Advantage, also known as Part C, is an alternative to Original Medicare where private insurers provide Medicare benefits, often combining hospital, medical, and prescription drug coverage with additional perks like dental, vision, and wellness programs.
Plans like HMOs and PPOs contract with networks of doctors and facilities to offer cost savings and coordinated care.
Key Takeaway
Kaiser Permanente’s Medicare Advantage plans deliver comprehensive, high-quality coverage in nine states and Washington D.C. When selecting a plan, consider your location, budget, and health needs. Remember to enroll during designated periods to access these plans for 2025.
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