Ever since 1945, Kaiser Permanente, an American integrated managed care consortium, has been providing health care for Americans with its hospitals, medical groups and health plans. Today, Kaiser has one of the country’s largest nonprofit health care plans and provides coverage for over 12 million people enrolled in the program.
Medicare recipients can enroll in a Kaiser Permanente program if they are a resident of Hawaii, Washington, Oregon, California, Colorado, Maryland, Virginia, Georgia, or the District of Columbia.
Whether you are already enrolled in a Kaiser Permanente health care plan and trying to decide if you should keep it when you enroll for Medicare benefits, or you are considering enrolling now, you may be wondering how your Original Medicare benefits will work together with a Kaiser Permanente health care plan. Here is some information that can help you decide about your future health care insurance.
How do your Original Medicare benefits work together with Kaiser?
Some Original Medicare recipients who have coverage with both Parts A (hospital insurance) and B (medical insurance) find they still have to pay more for the health care services than they can afford and may benefit from additional coverage.
While Original Medicare insurance covers 80 percent of medical and hospital expenses, beneficiaries are responsible for the remaining 20 percent, as well as copayments, coinsurance, and deductibles. And, unless you have additional coverage through a prescription drug (Part D) plan, you end up paying for all your medications out of pocket. In addition, it is possible that you have substantial out of pocket expenses for vision, hearing, and dental care.
If you live in a state that offers Kaiser Permanente Medicare Advantage plans, you can get full coverage that includes Original Medicare Parts A and B, prescription drug coverage (Part D), and additional optional benefits like hearing, vision, and dental care.
In general, private insurance companies across the United States offer Medicare Advantage (Part C) plans to those who are eligible for Medicare. What plan is available in your location depends on what insurance companies are approved by Medicare to sell Part C plans.
When can you enroll in a Kaiser Permanente Medicare Advantage plan?
Most people are enrolled in Medicare Part A automatically when they qualify due to age or disability. You can enroll in Part B or choose to get your Part A and Part B benefits through a Medicare Advantage (Part C) plan during a period of time called your initial enrollment period. You may risk paying a late enrollment penalty if you decide to enroll later.
Your initial enrollment period begins three months before your 65th birthday month and continues for three months after the end of your 65th birthday month. This is a period of seven months total.
If you miss your initial enrollment period, you can sign up during the annual general enrollment period which runs from January 1st to March 31st. you may have to pay a late enrollment penalty though.
Adults of any age who are eligible for Medicare due to a disability or end-stage renal disease can also enroll in a Kaiser Permanente Medicare Advantage plan once they have been approved for Medicare.
If you have a current Medicare Advantage plan with another insurance company or are insured by a non-Medicare company but are now eligible for Medicare, you may switch to a Kaiser Permanente plan if you wish. When your enrollment is finalized, do not forget to cancel your previous plan so you are not paying for two premiums.
If you live in a state that offers Kaiser Permanente health care insurance, you can call a representative at a local office for more information about the plans they offer.
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