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


Medicare Plan Details

2020 Plan
Monthly Premium
(select county for price)

 

by Kaiser Permanente
Additional Coverage
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

 

$30
$30
$0
$0
$6,700 In-network
No
No
Yes
Yes

Medical Benefits

Doctor Services

$10 per visit
$35 per visit

Tests, labs, & imaging

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

Hospital Services

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

Therapy services

$35
$35

Mental health services

$10
$20
$10
$20

Opioid treatment services

Covered

Other services

20% per item
20% per item
$0 copay

Prescription Drug Benefits

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

Part B Drugs

$0-47
$0-47

Extra Benefits

Hearing

$35
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
$11-69
$40-755
$47-1,047
$76-836
$72-429
$30-3,658

Vision

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

Other benefits

Not covered
Not covered
Not covered
Not covered
Not covered
Limited coverage
Limited coverage
 4.5
 5
 5
 4
 4
No Rating

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