Kaiser Permanente Senior Advantage B Only North (HMO)


Medicare Plan Details

2021 Plan
Monthly Premium
(select county for price)

 

by Kaiser Permanente
Additional Coverage
Hearing Vision
Overall Government Star Rating
 5.0
out of 5 stars

State: California

Select your county to view the price for this plan

 


Plan Type

Medicare Advantage (Part C) with Prescription Drug (Part D)

Medicare Advantage combines Part A and Part B. This plan = Part A + Part B + Part D

 

$398
$371
$27
$0
$6,700 In-network
No
Yes
Yes
No

Medical Benefits

Doctor Services

$30 copay per visit
$35 copay per visit

Tests, labs, & imaging

$35 copay
$0-35 copay
$55-215 copay
$55 copay
$90 copay per visit (always covered)
$30 copay per visit (always covered)

Hospital Services

$285 per day for days 1 through 7
$0 per day for days 8 through 999
$0-250 copay per visit

Skilled nursing facility

$0 per day for days 1 through 20
$100 per day for days 21 through 100

Preventive services

$0 copay

Ambulance

$200 copay

Therapy services

$40 copay
$0-40 copay

Mental health services

$15 copay
$30 copay
$15 copay
$30 copay

Opioid treatment services

Covered

Other services

0-20% coinsurance per item
20% coinsurance per item
$0 copay

Prescription Drug Benefits

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

TiersInitial coverage phaseGap coverage phase1Catastrophic coverage phase
Preferred Generic$6.00 copay$6.00 copay$3.00 copay
Generic$18.00 copay$18.00 copay$3.00 copay
Preferred Brand$47.00 copay$12.00 copay
Non-Preferred Drug
Specialty Tier33%$12.00 copay
1 For all other drugs, you pay 25% for generic drugs and 25% for brand-name drugs.

Part B Drugs

$0-47 copay
$0-47 copay

Extra Benefits

Hearing

$35 copay
Not covered
Not covered
Not covered
Not covered

Preventive Dental

Not covered
Not covered
Not covered
Not covered

Comprehensive dental

Not covered
Not covered
Not covered
Not covered
Not covered
Not covered
Not covered

Vision

$30 copay
$0 copay
$0 copay
$0 copay
$0 copay
Not covered

Other benefits

Not covered
Limited coverage
Not covered
Not covered
Limited coverage
Limited coverage
Limited coverage
 5
 5
 5
 4
 5
 5
 5
 5
 5
 5
 5

When Can I Sign Up for Medicare?

Enter your birthday month and year to learn when you can sign up for different Medicare plan options.

 

 


Advertisement

Medicare Health Plans

New Plan Sign Up Help
Quote & Compare

 

Medicare65quote

Get Quote  

 

-or call-
TTY 711

Get advice from Licensed Insurance Agents

No obligation to enroll. Find your plan online or speak with a licensed insurance agent to get help signing up for the right plan for you! Plan availability depends on your location. Licensed agents may not be able to provide assistance for all plans shown on this site.