Kaiser Permanente Medicare Advantage w/o Part D (HMO)


Medicare Plan Details

2021 Plan
Monthly Premium
(select county for price)

 

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

State: Maryland

Select your county to view the price for this plan

 


Plan Type

Medicare Advantage (Part C)

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

 

$10
$10
$0
$0
$6,900 In-network
No
Yes
Yes
Yes

Medical Benefits

Doctor Services

$10 copay per visit
$35 copay per visit

Tests, labs, & imaging

$0 copay
$0 copay
$100 copay
$10 copay
$90 copay per visit (always covered)
$35 copay per visit (always covered)

Hospital Services

$225 per day for days 1 through 5
$0 per day for days 6 through 90
$0-200 copay per visit

Skilled nursing facility

$0 per day for days 1 through 20
$150 per day for days 21 through 100

Preventive services

$0 copay

Ambulance

$250 copay

Therapy services

$35 copay
$35 copay

Mental health services

$10 copay
$20 copay
$10 copay
$20 copay

Opioid treatment services

Covered

Other services

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

Part B Drugs

$0-47 copay
$0-47 copay

Extra Benefits

Hearing

$35 copay
Not covered
Not covered
Not covered
Not covered

Preventive Dental

Covered under office visit
Covered under office visit
Covered under office visit
Covered under office visit

Comprehensive dental

$0-55 copay
$11-69 copay
$40-755 copay
$47-1,047 copay
$76-836 copay
$72-429 copay
$30-3,658 copay

Vision

$10-35 copay
$0 copay
$0 copay
$0 copay
$0 copay
Not covered

Other benefits

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

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