Quick Kaiser Foundation Medicare Advantage Plans Review
KFF-Logo Kaiser Foundation Medicare Plans provide quality, affordable health care. However, you must use the Kaiser Permanente health care network except in an emergency.
Medicare rating: 5 stars A.M. Best financial strength rating: A+ BBB rating: A- NCQA rating: 4 to 4.5 stars Consumer Affairs rating: 4 stars J.D. Power ranking: 1st out of 10

The Kaiser Foundation is one of three subsidiaries of Kaiser Permanente. These are:

  • The Kaiser Foundation Health Plan offering health insurance
  • Kaiser Foundation hospitals and subsidiaries
  • Kaiser Permanente medical groups offering treatment

The Kaiser Foundation, established in 1945, is one of the largest not-for-profit health insurers providing coverage to 12.5 million members through its network of hospitals, medical centers, and physicians. Kaiser Permanente has a unique business model where physicians are paid a salary independent of the number of patients seen. This approach helps Kaiser provide best-of-class medical care.

Read on to learn more about Kaiser Foundation Medicare Advantage Plan options.

What do Kaiser Foundation Medicare Advantage Plans cover?

Kaiser Foundation Medicare Advantage Plans, also known as Kaiser Permanente Medicare Advantage Plans, are comparable in their scope of coverage to other Medicare Advantage Plans, offering all the benefits of Original Medicare, along with coverage for additional health services. Medicare Advantage Plans, also called Medicare Part C, often include prescription drugs, vision, and dental coverage, and wellness programs. Your out-of-pocket costs depend on the plan you choose, as do rules for how you get services, such as whether you have to choose a primary care doctor or get a referral to see a specialist.

Your hospital and medical insurance are covered and you’ll get prescription drug coverage with most plans. Additional benefits from Kaiser Foundation Medicare Advantage Plans may include:

  • Dental
  • Vision, including eyewear or contacts
  • Hearing, including hearing aids
  • Wellness program
  • Fitness benefit
  • Transportation
  • Telehealth
  • Over the counter drugs

What are Kaiser Foundation Medicare Advantage Plan options?

Kaiser Foundation offers three HMO Medicare Advantage Plans. With an HMO plan, you have a network of providers you need to use. This includes your primary doctor, and if you need specialist treatment, you must go to in-network providers and hospitals. In return, your medical expenses are generally lower than with other Medicare plans.

The Kaiser Foundation Advantage Plans differ in what you pay for services (your copay), additional benefits, and maximum annual out-of-pocket expenses. Depending on the plan, you’ll pay $10 per visit to your doctor and up to $50 for a specialist.

Kaiser Foundation Medicare Advantage Plans are available in eight states and Washington DC.

The following table demonstrates differences between the three 2022 Kaiser Permanente HMO plans in Baltimore, MD.

Kaiser Foundation Medicare Advantage Plans
Plan name Monthly premium Annual medical deductible Office visits Annual maximum out-of-pocket cost
Kaiser Permanente Medicare Advantage Baltimore Value (HMO) $0 None $10 primary care / $50 specialist $7,200
Kaiser Permanente Medicare Advantage Standard MD (HMO) $25 None $10 primary care / $40 specialist $6,900
Kaiser Permanente Medicare Advantage High MD (HMO) $142 None $5 primary care / $30 specialist $5,700

*Based on pricing in Baltimore City, MD.

Pros and cons of Kaiser Foundation Medicare Advantage Plans

What we like about Kaiser Foundation Medicare Advantage Plans The drawbacks of Kaiser Foundation Medicare Advantage Plans
  • There’s no annual deductible
  • Monthly premiums for Value and Standard plans are low
  • Doctor, lab, and pharmacy services are often under one roof
  • You must use Kaiser Permanente network doctors and facilities
  • Only three Medicare Advantage Plans
  • Premiums and benefits vary depending on your state and city

Kaiser Foundation Medicare Advantage Plans reviews and ratings

Kaiser Foundation Medicare Advantage Plans have a good reputation for medical care and customer satisfaction. While you’re limited to medical care from the Kaiser Permanente network, except in an emergency, you benefit from lower costs and no annual deductibles.

Trusted ratings and reviews can help you understand how an insurer’s plans stack up against the competition. See how Medicare, A.M. Best, the Better Business Bureau and more rate Kaiser Foundation’s Medicare Advantage Plans.

Medicare rating: 5 stars For 2022, Kaiser Foundation’s Medicare Advantage plans have an overall average rating of 5 stars from the Centers for Medicare & Medicaid Services. Find each plan’s star rating on Medicare.gov.
A.M. Best financial strength rating: A+ A.M. Best sets credit ratings for insurers. A.M. Best affirmed it’s A+ Financial Strength Rating (FSR) for Kaiser Permanente and its subsidiaries. An A+ rating indicates Kaiser Permanente has a superior ability to meet financial obligations.
BBB rating: A- The Better Business Bureau (BBB) rates Kaiser Foundation Health Plans at A-. The company has closed 75 complaints in the last three years.
NCQA rating: 4.5 to 5 stars The National Committee for Quality Assurance (NCQA) rates Kaiser Foundation Medicare Health Plans highly, with plans in three states scoring 5 out of 5 and in others 4.5 out of 5. Customer satisfaction ratings are slightly lower at 3.5, but this is compensated by higher ratings for prevention and treatment. Kaiser Foundation Plans have NCQA accreditation.
Consumer Affairs rating: 4 stars Customer reviews on Consumer Affairs give Kaiser Permanente a 4 out of 5 rating. Based on 2,103 ratings over the last year, reviewers expressed high satisfaction levels with the quality of care and low medical costs. A few reviewers complained of poor administration and unsatisfactory arbitration processes.
J.D. Power ranking: 1st out of 10 In its 2021 Medicare Advantage Study, J.D. Power measured Medicare Advantage Plan satisfaction based on coverage and benefits, provider choice, cost, customer service, information and communication, and billing and payment. Kaiser Foundation health plan scored 846 points out of 1,000 and came in first out of the top 10 Medicare Advantage providers.
Medicare consultant

LeRon Moore has guided Medicare beneficiaries and their families as a Medicare professional since 2007. First as a Medicare provider enrollment specialist and now a Medicare account executive, Moore works directly with Medicare beneficiaries to ensure they understand Medicare and Medicare Advantage Plans.

Moore holds a bachelor’s degree from Southern New Hampshire University and is A+ Certified with a Medical Records Clerk Certification and Medical Terminology Certification from Midlands Technical College.

He’s passionate about educating, informing, and resolving issues concerning Medicare and Medicare Advantage Plans, and considers it imperative that he does all he can to educate and inform the senior community as much as possible about Medicare.