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Why Kaiser Permanente

Affordable medical and prescription drug coverage–all in one health plan

There are many ways our health plans are designed to save you money and valuable time:

A $0 or low monthly premium*

Our Medicare health plans offer you more coverage than Original Medicare, including Part D prescription drugs benefits, all for a $0 or low monthly premium*. You get both quality care and affordable coverage, plus additional benefits that work together to help you thrive.

Preventive Care

Many health services and features are included at no extra charge, or with low copay or coinsurance, so it's easier to live healthy. We offer many preventive services—like mammograms, flu shots, cholesterol screenings, and an Annual Wellness Visit—at no additional cost.

Prescription Drug Coverage

Our health plan coverage includes low copays for prescriptions which could help lower your total cost of care.

Health and Wellness Tools

Take advantage of a wide range of convenient ways to stay well — from health classes at our locations to one-on-one support from a wellness coach. You can also get resources like our Every Body Walk! mobile app to track your activity, and My Health Manager to email your doctor’s office, view most test results, schedule routine appointments, and refill most prescriptions online.

 

*You must continue to pay your Medicare Part B premium and any other applicable Medicare premium(s), if not otherwise paid by Medicaid or another third party.

A wide selection of great doctors and specialists

We make it easy to choose the right Kaiser Permanente doctor for you, and if you change your mind, for any reason, you can switch to a new Kaiser Permanente doctor at any time. All of our available doctors welcome our Medicare health plan members.

With our online physician directory, you can browse profiles of doctors in your area and get information on their education, background, credentials, specialties, profile photos, and more.

We also offer a wide range of specialists, who are connected to your doctor and your electronic health records, so they can work together and give you the care you need.

You can choose and change your doctor at any time, for any reason, by visiting kp.org/mydoctor or calling Member Services.

 

The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.

Convenient features designed to help you thrive

Get the care and support you need with a Kaiser Permanente Medicare health plan.

Under-One-Roof Convenience

You can see your doctor or specialist, visit a lab, and pick up your prescriptions—often on the same day and in one location, so you spend less time and money on things like transit and parking.

A Connected Team

Your entire care team is connected electronically, so they can easily access your medical records and work together, for you. This means less paperwork, less chance of errors, and no unnecessary repeat tests.

Manage Your Health Care Online

You can refill prescriptions, schedule appointments, view lab results, email your doctor’s office, and more, all from the convenience of your home. You can even download our mobile app to access care on the go.

Enjoy Peace of Mind When You Travel

Rest easy no matter where you are. As a Kaiser Permanente Medicare health plan member, you’re covered for emergency or urgent care from any medical provider while traveling—even when you’re outside your Kaiser Permanente service area. Download our brochure to learn more ♦.

Note: Kaiser Permanente Medicare Plus Basic Option plan does not include urgent or emergency care outside the United States except under limited circumstances.

 

  
Medicare Star Quality Ratings

Medicare Star Quality Ratings

Our Medicare health plans for 2016 received the highest possible rating, 5 out of 5 stars, in California, Colorado, Hawaii, Maryland, Oregon, Virginia, Washington, and Washington D.C., and 4.5 out of 5 stars in Georgia.1 The star ratings are given by the Centers for Medicare & Medicaid Services (CMS), which rates Medicare health plans in categories that include preventive care, prescription drug services, and member satisfaction.

Why it's important for you:

You get a plan that consistently delivers high quality care and great service to its Medicare members.

NCQA Medicare Health Insurance Plan Rankings

NCQA Medicare Health Insurance Plan Ratings2

All our Kaiser Permanente Medicare health plans are the highest rated in every area we serve, according to the National Committee for Quality Assurance's (NCQA) annual national report. In the 2015-2016 study, only nine Medicare health plans (out of nearly 400) were rated a 5 out of 5, and Kaiser Permanente has five of them. The independent NCQA rates health plans based on customer service, prevention, and treatment.3

Why it's important for you:

You'll feel secure knowing you're getting outstanding health care. Our doctors, nurses, and staff all work together to give you high-quality care that shines on a national level.

Our high customer service rating reflects our commitment to treating you well, whether you come in for a visit or call us. We know that giving you great care starts with giving you great service.

Medicare WebWatch Certification of Excellence Award

Medicare WebWatch Certification of Excellence Award

Kaiser Permanente's Medicare health plan website — the one you're visiting right now — received the highest overall rating† in 2015 from Medicare WebWatch, and is one of only 10 sites to be recognized as an industry benchmark. MedicareWebWatch certification signifies Medicare plan websites that offer "Excellence in Website Content, Connectivity, Design and Transparency".4

Why it's important for you:

Get easy access to information on Kaiser Permanente Medicare health plans, find answers to questions about eligibility and enrollment, apply for a plan online, and more, all on a website that's easy to use.

 

Learn more about Kaiser Permanente’s awards and honors at kp.org/quality.

1Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next. Centers for Medicare & Medicaid Services Health Plan Management System, Plan Ratings 2016. Kaiser Permanente Contract #H0524, #H0630, #H1170, #H1230, #H2150, #H9003.

2The National Committee for Quality Assurance (NCQA) is a private, not-for-profit organization dedicated to improving health care quality. It issues health insurance plan rankings and Quality Compass Health Plan Quality Measures for Commercial and Medicare plans each year.

3In 2015-2016 NCQA evaluated 376 Medicare health plans with sufficient data to be rated. NCQA’s Medicare Health Insurance Plan Ratings 2015–16, National Committee for Quality Assurance, 2015; Kaiser Foundation Health Plan of Colorado — HMO (rated 4.5 out of 5), Kaiser Foundation Health Plan of Georgia — HMO (rated 5 out of 5), Kaiser Foundation Health Plan Hawaii — HMO (rated 4.5 out of 5), Kaiser Foundation Health Plan of the Mid-Atlantic States — HMO (rated 5 out of 5), Kaiser Foundation Health Plan of Northern California — HMO (rated 5 out of 5), Kaiser Foundation Health Plan of the Northwest — HMO (rated 5 out of 5), Kaiser Foundation Health Plan of Southern California — HMO (rated 5 out of 5).

4The independent research firm rated 168 Medicare health plan websites in 2015 nationwide.

Feel confident with Star quality

Now you have a smart, easy way to compare Medicare health plans, apples to apples. It’s called the Medicare Star Quality Ratings. The ratings are developed every year by the Centers for Medicare & Medicaid Services (CMS), the federal agency that administers the Medicare program.*

Whether you’re choosing or changing coverage, these ratings are a simple, fair way to compare plans in your area — and they may be the single most important resource you use.

2016 ratings

Our Medicare health plans for 2016 received Medicare’s highest possible rating, 5 out of 5 stars, in California, Colorado, Hawaii, Maryland, Oregon, Virginia, Washington, and Washington D.C., and 4.5 out of 5 stars in Georgia.1 Detailed information on 2016 plan ratings will be available shortly. Please check this area again soon.

2015 ratings

  California♦ Also available in Chinese [中文本]♦ and Spanish (en español)

 Colorado♦ Also available in Spanish (en español)

 Georgia

 Hawaii

 Maryland, Virginia, Washington D.C.

 Oregon and Washington

Who created the Medicare Star Quality Ratings?

The Medicare Star Quality Rating System was developed by the Centers for Medicare & Medicaid Services (CMS), the federal agency that administers the Medicare program.* The ratings are updated annually based on ongoing monitoring and analysis.

The Medicare Star Quality Rating System is unique because it's based on more than 40 measures including clinical performance, customer service, and member satisfaction. CMS uses 5 main sources to measure Medicare plans and compile the ratings:

  • The HEDIS® (Health Plan Employer Data and Information Set)
  • The Consumer Assessment of Healthcare Providers and Systems (CAHPS) member satisfaction survey
  • Surveys of members' health status
  • Information from members' complaints and appeals
  • Medicare's own monitoring activities

Why ratings are important

The Medicare Star Quality Ratings are a simple, authoritative starting point and may be the single most important criterion you can use to tackle the challenge of comparing Medicare health plans in your area.

How ratings work:

Each Medicare health plan is assigned an overall rating from 5 stars to 1 star, based on the plan’s performance in more than 40 specific measures across 9 general categories. The ratings are updated annually based on ongoing monitoring and analysis. However, some plans may be too new or not have enough data to be rated.

What the number of stars represents

5 Excellent performance
4 Above average performance
3 Average performance
2 Below average performance
1 Poor performance

What the stars assess

The ratings system analyzes Medicare health plan performance across more than 40 distinct measures. Each area is assessed individually and assigned a star quality rating to reflect that assessment. The highest rating is 5 stars for excellent performance. The lowest rating is 1 star for poor performance.

The Centers for Medicare & Medicaid Services measures how well health and prescription drug plans perform on more than 40 items, which are grouped into different categories:

Medicare health plan rating categories

  1. Stay healthy: screenings, tests, and vaccines
  2. Managing chronic (long-term) conditions
  3. Member experience with the health plan
  4. Member complaints, problems getting services, and improvement in the health plan's performance
  5. Health plan customer service

Medicare drug plan rating categories

  1. Drug plan customer service
  2. Member complaints, problems getting services, and improvement in the drug plan's performance
  3. Member experience with drug plan
  4. Patient safety and accuracy of drug pricing

Learn more about the ratings at the Medicare web site.

1Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next. Centers for Medicare & Medicaid Services Health Plan Management System, Plan Ratings 2016. Kaiser Permanente Contract #H0524, #H0630, #H1170, #H1230, #H2150, #H9003.

*A branch of the U.S. Department of Health and Human Services.


♦You will need the free Adobe Acrobat Reader† to read this file.
†Kaiser Permanente is not responsible for the content or policies of external Internet sites.



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