KP Medicare Liberty H2960-009 (HMO)

by Kaiser Permanente

2027 Medicare Advantage plan available in Nevada

Plan ID H2960-009-0

Additional coverage:

HearingVisionDental

Medicare Advantage HMO $0 premium 5.0 Overall

Monthly plan premium $0 / mo

Annual deductible $0 / yr

Max out-of-pocket · in-network $2,350 / yr

5.0 Overall Government Star Rating 2027 · out of 5 stars

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Plan Overview

KP Medicare Liberty H2960-009 (HMO) is a Medicare Advantage Plan Without Prescription Drugs, which is available in Nevada and offered by the health insurance company Kaiser Permanente. This plan's network type is HMO, which determines the in-network doctors who accept the plan and whether a referral is needed.

Plan Name KP Medicare Liberty H2960-009 (HMO)

Insurance Carrier Kaiser Permanente

Plan Type Medicare Advantage Plan Without Prescription Drugs

Network Type HMO

Cost Summary

KP Medicare Liberty H2960-009 (HMO) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out-of-pocket cost sharing of $2,350. The most common costs people evaluate when choosing a plan are listed here; a full list of benefit costs is defined below.

Monthly Premium $0 / mo

Annual Deductible $0 / yr

Max Out-of-Pocket · in-network $2,350 / yr

Primary doctor visit $0-$10 copay

Specialist visit $45 copay

ER visit $140 copay

Ambulance $250 copay

Additional Benefits and Coverage

KP Medicare Liberty H2960-009 (HMO) is a Medicare Advantage plan which does not include Medicare Part D prescription drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. KP Medicare Liberty H2960-009 (HMO) includes coverage for hearing, vision, dental.

Part D Prescription Drug Coverage No

Dental Yes

Vision Yes

Hearing Yes

Nationwide Coverage No

Other benefits

Fitness benefit Limited coverage

Over-the-counter drug benefits Limited coverage

In-home support services Not covered

Home & bathroom safety devices Limited coverage

Meals for short duration Not covered

Annual physical exams Limited coverage

Telehealth Limited coverage

Medical Benefits

Doctor Services

Primary doctor visit In-network: $0-$10 copay
Out-of-network: $0-$10 copay

Specialist visit In-network: $45 copay
Out-of-network: $45 copay

Tests, labs & imaging

Diagnostic tests & procedures In-network: $0-$300 copay
Out-of-network: $0-$300 copay

Lab services In-network: $0-$120 copay
Out-of-network: $0-$120 copay

Diagnostic radiology services (like MRI) In-network: $0-$130 copay
Out-of-network: $0-$130 copay

Outpatient x-rays In-network: $60 copay
Out-of-network: $60 copay

Emergency care $140 copay

Urgent care $25-$65 copay

Hospital Services

Inpatient hospital coverage Tier 1
$350 per day for days 1-4
$0 per day for days 5-90
$350 Lifetime Reserve Days for days 1-4
$0 Lifetime Reserve Days for days 5-60
$0 per stayTier 2
$440 per day for days 1-5
$0 per day for days 6-90
$440 Lifetime Reserve Days for days 1-5
$0 Lifetime Reserve Days for days 6-60
$0 per stay

Outpatient hospital coverage In-network: $0-$440 copay
Out-of-network: $0-$440 copay

Skilled nursing facility

Skilled nursing facility Tier 1
$20 per day for days 1-20
$200 per day for days 21-34
$0 per day for days 35-100

Preventive services

Preventive services In-network: $0 copay
Out-of-network: $0 copay

Ambulance

Ground ambulance In-network: $250 copay
Out-of-network: $250 copay

Therapy services

Occupational therapy visit In-network: $20 copay
Out-of-network: $20 copay

Physical therapy & speech & language therapy visit In-network: $20 copay
Out-of-network: $20 copay

Mental health services

Outpatient group therapy with a psychiatrist In-network: $45 copay
Out-of-network: $45 copay

Outpatient individual therapy with a psychiatrist In-network: $45 copay
Out-of-network: $45 copay

Outpatient group therapy visit In-network: $45 copay
Out-of-network: $45 copay

Outpatient individual therapy visit In-network: $45 copay
Out-of-network: $45 copay

Opioid treatment services

Opioid treatment services Covered

Other services

Durable medical equipment (like wheelchairs & oxygen) In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Prosthetics (like braces, artificial limbs) In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Diabetes supplies In-network: 10% coinsurance
Out-of-network: 10% coinsurance

Medicare star rating

Each year the federal government rates Medicare Advantage and Part D plans on a 5-star system covering quality of care, chronic-condition management, member experience, and customer service. For 2027, KP Medicare Liberty (HMO) earned an overall rating of 5.0 stars — better than Nevada's state average of 4.0 stars.

Rating category This plan State average

Overall star rating ★ 5.0 4.0

Health plan quality

Summary rating of health plan quality ★ 5.0 3.9

Staying healthy: screenings, tests & vaccines ★ 4.0 3.4

Managing chronic (long-term) conditions ★ 5.0 3.8

Member experience with health plan ★ 5.0 3.4

Member complaints & changes in performance ★ 5.0 3.8

Health plan customer service ★ 4.0 4.5

Extra Benefits

Hearing

Hearing exam In-network: $0 copay
Out-of-network: $0 copay

Fitting/evaluation In-network: $0 copay
Out-of-network: $0 copay

Hearing aids - prescription In-network: $0 copay
Out-of-network: $0 copay

Hearing aids - over the counter Not covered

Preventive dental

Oral exam In-network: $0 copay
Out-of-network: $0 copay

Cleaning In-network: $0 copay
Out-of-network: $0 copay

Fluoride treatment Not covered

Dental x-rays In-network: $0 copay
Out-of-network: $0 copay

Comprehensive dental

Restorative services In-network: 0% coinsurance
Out-of-network: 0% coinsurance

Endodontics In-network: 0% coinsurance
Out-of-network: 0% coinsurance

Periodontics In-network: 0% coinsurance
Out-of-network: 0% coinsurance

Prosthodontics, removable In-network: 0% coinsurance
Out-of-network: 0% coinsurance

Prosthodontics, fixed Not covered

Maxillofacial prosthetics Not covered

Implant services Not covered

Oral and maxillofacial surgery In-network: 0% coinsurance
Out-of-network: 0% coinsurance

Orthodontics Not covered

Adjunctive general services Not covered

Vision

Routine eye exam In-network: $0 copay
Out-of-network: $0 copay

Contact lenses In-network: $0 copay
Out-of-network: $0 copay

Eyeglasses (frames & lenses) In-network: $0 copay
Out-of-network: $0 copay

Eyeglass frames (only) In-network: $0 copay
Out-of-network: $0 copay

Eyeglass lenses (only) In-network: $0 copay
Out-of-network: $0 copay

Upgrades In-network: $0 copay
Out-of-network: $0 copay

Plan documents & tools

Plan details (carrier site)Provider directory Drug list (formulary)

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