Kaiser Permanente’s insurance and Medicare plans have always gotten the best ratings, and they are often far ahead of competitors. It is different from other companies because it has both insurance and medical care as parts of the same company. This is wonderful for people who require their health insurance and health care to work together smoothly. However, these policies are not a good fit for people who want more freedom to choose their healthcare providers.
What’s Kaiser Permanente Insurance?
Both Kaiser’s and Medicare plans are highly rated, getting between 4 and 5 stars overall based on how well they cover and treat their customers. This company’s average rating is greater than many other large insurance companies.
Since the company only works in a few states, many people may not be able to get these plans. But if you live in a place where Kaiser is active, these policies could provide excellent coverage at prices that are easy on your budget.
Different types of Kaiser insurance have different costs. For example, Kaiser’s family and individual health insurance plans are usually less expensive than those from other companies, while its Medicare Advantage policies are often more expensive than those from other companies.
In both cases, Kaiser’s integrated system stands out because of the quality of care it provides. The insurance coverage works directly with Kaiser’s hospitals and medical centers. This makes it easier for you to file claims and get coverage. It also helps Kaiser keep its costs low to give you policies at a good price.
The bad thing about Kaiser health insurance is that most plans don’t cover care outside their network unless it’s urgent or an emergency. If you want a more flexible insurance plan, we recommend Anthem or Blue Cross Blue Shield, which 90% of doctors in the United States acknowledge.
Where can I find Kaiser Permanente?
Kaiser Permanente sells health insurance plans in eight states and the District of Columbia. This includes parts of the Mid-Atlantic, the West Coast, and other places. If Kaiser isn’t accessible in your state, think about one of our other top-rated health insurance companies.
It’s possible that Kaiser Permanente only works in a few states. However, it is still a major insurance company because it has a big market share in those areas. Based on data about who has signed up, Kaiser is one of the three largest health insurance companies for individuals in every state or region where it does business.
Health insurance plan choices
Kaiser Permanente has many kinds of health insurance, including plans for individuals, and families, Medicare, Medicaid, and health insurance for groups. Most Kaiser insurance plans seem to be HMOs (health maintenance organizations), which only cover care from doctors and hospitals in their network and usually have lower monthly costs.
You can only get medical care at Kaiser’s 700 clinics and 39 hospitals. You must also choose a primary care doctor who can send you to a specialist when necessary. People with long-term health problems worry that this integration of insurance and health care will make it harder for them to see specialists who aren’t part of Kaiser. Bear in mind that Kaiser may well have the same providers as yours.
Travelers can also have trouble with the limited network. When you are away from home, urgent care and emergency department services are the only ones covered at places not part of Kaiser. The company also has a special travel line to help you figure out your situation, coverage, or preapproval when traveling to another Kaiser provider network or out of the service area.
Plans for families and individuals
You can buy Kaiser health insurance plans through the Health Insurance Marketplace, which was set up by the Affordable Care Act, or you can buy them directly from the insurance company. But if you buy insurance through the marketplace, you can get tax credits for health insurance, which can lower your payments.
Kaiser Permanente plans include obtaining satisfactory coverages like free preventive care and screenings and financial protections like an out-of-pocket maximum. Kaiser’s plans are also divided into the three insurance categories below. You can select a Bronze Deductible strategy, a Gold Copayment plan, or a different combination.
- Plans with a health savings account (HSA): These high-deductible plans are the least expensive ones that Kaiser offers. They let you set up a health savings account, so you don’t have to pay taxes on the funds you’ll use to pay for doctor visits and other health care services.
- Plans with deductibles work like traditional insurance because you pay for most health services out of your pocket until you reach the deductible amount. Then, your plan will tell you how much coinsurance you have to pay.
- Copayment plans: The monthly rates for these Gold and Platinum plans are high. But they don’t have to pay anything. If you expect to have a lot of medical costs, these plans can save you money because you’ll only have to pay a copayment for covered services.
Medicare
Kaiser Permanente also has Medicare plans, which can be bought directly from the company or via Medicare.gov.
Possible plans:
- Medicare Advantage plans (Medicare Part C) add to the coverage you get from your Original Medicare by giving you more benefits that save you money and help you pay for prescription drugs. Your health coverage can be made easier with these bundled plans, and Kaiser has been named one of our best Medicare Advantage providers.
- Kaiser calls its Part C plans that cover dental care, hearing aids, eyewear, and Medicare Advantage Plus plans.
- Prescription coverage can only be bought as part of a Medicare Advantage plan that covers everything. No Medicare Part D plans just cover drugs on their own.
Kaiser doesn’t offer Medicare Supplement (Medigap) plans, but our best Medicare Supplement providers, like UnitedHealthcare and Aetna, do.
Medicaid and other programs for people with low incomes
Kaiser Permanente also takes part in programs run by Medicaid. If you get low-income health insurance through your government agency, your plan may be through Kaiser. Kaiser also has a program called Charitable Health Coverage that helps people who don’t qualify for public or private health insurance get coverage and access to care. A Medical Income Support program enables low-income, uninsured, and underserved people to get free or low-cost health care.
Insurance from an employer or a group
Kaiser may have a wider range of plan options for groups than for people who buy insurance independently. For example, some places have PPO plans, which cover more than just Kaiser’s facilities and doctors regarding medical care. These PPO plans may not be as good as Kaiser’s HMO plans. In Washington, for instance, we do not suggest the Kaiser Options PPO plan because of its low customer satisfaction.
Coverage, member resources, and unique features
Kaiser Permanente’s health care coverage stands out in two ways:
- It makes tracking costs and handling claims easier because it combines health insurance with health care.
- The strong program for preventive care gives people access to screening tests, health resources, programs to help them live healthier lives, and health classes.
Depending on your plan, the services Kaiser offers its members may include the following:
- Services for women’s health
- Addiction and recovery in mental health
- Chiropractic care
- Coaching for wellness
- Prescription delivery
- Dental care (add-on)
- Vision care (add-on)
The company also stands out from the rest because it has powerful digital tools. Among the plans:
- Phone, video, or email telemedicine
- Health records, like test results, doctor’s notes, and vaccination records, can be viewed online.
- A cost calculator
- Being able to set up or cancel appointments
- Managing your health insurance, including keeping track of your deductible,
There are also fitness resources, like discounted gyms, health calculators, and massages.
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