Go Back

Kaiser Permanente Senior Advantage Care Plus (HMO-POS)

H1170 - 013 - 0
4.5 out of 5 stars (4.5 / 5)

kaiser-permanente medicare provider logo

Kaiser Permanente Senior Advantage Care Plus (HMO-POS) is a Medicare Advantage Plan by Kaiser Permanente.

This page features plan details for 2025 Kaiser Permanente Senior Advantage Care Plus (HMO-POS) H1170 – 013 – 0 available in Atlanta Metro Area.

Locations

Kaiser Permanente Senior Advantage Care Plus (HMO-POS) is offered in the following locations.

Cherokee County, Georgia
Clayton County, Georgia
Cobb County, Georgia

Click to see more locations

Plan Overview

Kaiser Permanente Senior Advantage Care Plus (HMO-POS) offers the following coverage and cost-sharing.

Insurer:Kaiser Permanente
Health Plan Deductible:$0
MOOP:$6,500 In-network
Drugs Covered:Yes

Ready to sign up for Kaiser Permanente Senior Advantage Care Plus (HMO-POS) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 / TTY 711.

M-F: 8:00 am – 10:00 pm EST

Sat-Sun: 8:00 am – 9:00 pm EST

Medicare Part B Give Back Benefit

The Part B Premium Reduction (Medicare Part B Give Back Benefit) lowers the cost of some Medicare Advantage plans. 

Kaiser Permanente Senior Advantage Care Plus (HMO-POS) qualifies for a monthly Medicare Give Back Benefit of $10.00.

Premium Reduction:$10.00

Premium Breakdown

Kaiser Permanente Senior Advantage Care Plus (HMO-POS) has a monthly premium of $0.00. This amount includes your Part C and D premiums but does not include your Part B premium. The following is a breakdown of your monthly premium with Part B costs included.
Part B Part C Part D Part B Give Back Total
$185.00 $0.00 $0.00 $10.00 $
Please Note:
  • Your Part B premium may differ based on factors including late enrollment, income, and disability status.
  • You may also qualify for “Extra Help” on drug costs. See the Part D Premium Reduction section below for more details.

Drug Info

Kaiser Permanente Senior Advantage Care Plus (HMO-POS) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.

Drug Deductible: $0.00
Drug Out-Of-Pocket maximum: $2,000.00
Drug Benefit Type: Enhanced Alternative

Part D Premium Reduction

The Low-Income Subsidy (also known as LIS or “Extra Help”) helps people with Medicare lower the cost of prescription drugs.

The table below shows how the LIS impacts the Part D premium of this plan.

Part DLIS Full
$0.00$0.00

Initial Coverage Phase

After you pay your $0.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $2,000.00. Once you reach that amount, you will enter the next coverage phase.

Catastrophic Coverage Phase

After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $2,000.00, you pay nothing for Medicare Part D covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit. Please note, that this plan has a Enhanced Alternative benefit type.

Additional Benefits

Kaiser Permanente Senior Advantage Care Plus (HMO-POS) also provides the following benefits.

Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?

    • In-Network: Yes, contact plan for further details

Comprehensive Dental

  • Adjunctive General Services
    • In-Network: 75 Coins – 0.00 Copay (Limits Apply, Authorization Required, Referral Required)
  • Oral and Maxillofacial Surgery
    • In-Network: 75 Coins – 22.00 Copay (Limits Apply, Authorization Required, Referral Required)
  • Periodontics
    • In-Network: 75 Coins – 0.00-400.00 Copay (Limits Apply, Authorization Required, Referral Required)
  • Prosthodontics, removable
    • In-Network: No Coins – 420.00-480.00 Copay (Limits Apply, Authorization Required, Referral Required)
  • Restorative Services
    • In-Network: 75 Coins – 28.00-580.00 Copay (Limits Apply, Authorization Required, Referral Required)

Diagnostic and Preventive Dental

  • Dental X-Rays
    • In-Network: 75 Coins – 0.00 Copay
  • Fluoride Treatment
    • In-Network: 75 Coins – 0.00 Copay
  • Oral Exams
    • In-Network: 75 Coins – 0.00 Copay
  • Other Diagnostic Dental Services
    • In-Network: 75 Coins – 0.00 Copay (Limits Apply)
  • Other Preventive Dental Services
    • In-Network: 75 Coins – 0.00 Copay (Limits Apply)
  • Prophylaxis (cleaning)
    • In-Network: 75 Coins – 0.00 Copay

Diagnostic procedures/lab services/imaging

  • Diagnostic tests and procedures
    • Out-of-Network: $50 copay (Authorization Required, Referral Required)
  • Diagnostic radiology services (e.g., MRI)
    • Out-of-Network: $50 copay (Authorization Required, Referral Required)
  • Outpatient x-rays
    • Out-of-Network: $50 copay (Authorization Required, Referral Required)
  • Diagnostic radiology services (e.g., MRI)
    • In-Network: $10-290 copay (Authorization Required, Referral Required)
  • Diagnostic tests and procedures
    • In-Network: $0-35 copay (Authorization Required, Referral Required)
  • Lab services
    • In-Network: $0-35 copay (Authorization Required, Referral Required)
    • Out-of-Network: $50 copay (Authorization Required, Referral Required)
  • Outpatient x-rays
    • In-Network: $10-50 copay (Authorization Required, Referral Required)

Doctor visits

  • Primary
    • In-Network: $10 copay per visit
  • Specialist
    • In-Network: $0-35 copay per visit (Referral Required)
  • Primary
    • Out-of-Network: $25 copay per visit
  • Specialist
    • Out-of-Network: $0-50 copay per visit (Referral Required)

Emergency care/Urgent care

  • Emergency
    • $125 copay per visit (always covered)
  • Urgent care
    • $35 copay per visit (always covered)

Foot care (podiatry services)

  • Foot exams and treatment
    • Out-of-Network: $0-50 copay (Authorization Required, Referral Required)
  • Routine foot care
    • Not covered
  • Foot exams and treatment
    • In-Network: $35 copay (Authorization Required, Referral Required)

Ground ambulance

    • In-Network: $275 copay

Health plan deductible

    • $0

Hearing

  • Medicare-Covered Hearing Exam
    • Out-of-Network: $0-50 copay
  • Hearing aids OTC
    • Not covered
  • Fitting/evaluation
    • Not covered
  • Hearing aids – inner ear
    • Not covered
  • Hearing aids – over the ear
    • Not covered
  • Hearing aids – outer ear
    • Not covered
  • Medicare-Covered Hearing Exam
    • In-Network: $35 copay

Inpatient hospital coverage

    • Out-of-Network: Not Applicable (Authorization Required, Referral Required)
    • In-Network: $290 per day for days 1 through 7
      $0 per day for days 8 through 90
      $0 per day for days 91 and beyond (Authorization Required, Referral Required)

Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)

    • $6,500 In-network

Medical equipment/supplies

  • Durable medical equipment (e.g., wheelchairs, oxygen)
    • In-Network: 0-20% coinsurance per item (Authorization Required)
  • Diabetes supplies
    • In-Network: $0 copay per item
  • Prosthetics (e.g., braces, artificial limbs)
    • In-Network: 20% coinsurance per item (Authorization Required)

Medicare Part B drugs

  • Chemotherapy
    • In-Network: $0-47 copay or 0-20% coinsurance (Authorization Required)
    • Out-of-Network: 0-20% coinsurance (Authorization Required)
  • Other Part B drugs
    • In-Network: $0-47 copay or 0-20% coinsurance (Authorization Required)
    • Out-of-Network: 0-20% coinsurance (Authorization Required)

Mental health services

  • Inpatient hospital – psychiatric
    • In-Network: $290 per day for days 1 through 6
      $0 per day for days 7 through 90 (Authorization Required, Referral Required)
  • Outpatient group therapy visit with a psychiatrist
    • Out-of-Network: $25-50 copay (Authorization Required, Referral Required)
  • Outpatient individual therapy visit
    • Out-of-Network: $25-50 copay
  • Outpatient group therapy visit
    • In-Network: $17 copay
    • Out-of-Network: $25-50 copay
  • Outpatient individual therapy visit with a psychiatrist
    • Out-of-Network: $25-50 copay (Authorization Required, Referral Required)
  • Outpatient individual therapy visit
    • In-Network: $35 copay
  • Inpatient hospital – psychiatric
    • Out-of-Network: Not Applicable (Authorization Required, Referral Required)
  • Outpatient group therapy visit with a psychiatrist
    • In-Network: $17 copay (Authorization Required, Referral Required)
  • Outpatient individual therapy visit with a psychiatrist
    • In-Network: $35 copay (Authorization Required, Referral Required)

Optional supplemental benefits

    • Yes

Other health plan deductibles?

    • In-Network: No

Outpatient hospital coverage

    • In-Network: $0-275 copay per visit (Authorization Required)

Preventive care

    • In-Network: $0 copay
    • Out-of-Network: $0 copay

Rehabilitation services

  • Occupational therapy visit
    • In-Network: $35 copay (Referral Required)
  • Physical therapy and speech and language therapy visit
    • Out-of-Network: $50 copay (Authorization Required, Referral Required)
  • Occupational therapy visit
    • Out-of-Network: $50 copay (Referral Required)
  • Physical therapy and speech and language therapy visit
    • In-Network: $35 copay (Authorization Required, Referral Required)

Skilled Nursing Facility

    • In-Network: $0 per day for days 1 through 20
      $203 per day for days 21 through 100 (Authorization Required, Referral Required)
    • Out-of-Network: Not Applicable (Authorization Required, Referral Required)

Transportation

    • In-Network: $0 copay (Limits Apply)

Vision

  • Other
    • Not covered
  • Upgrades
    • Not covered
  • Contact lenses
    • In-Network: $0 copay (Limits Apply)
  • Eyeglass frames
    • In-Network: $0 copay (Limits Apply)
  • Routine eye exam
    • In-Network: $0 copay (Limits Apply)
  • Eyeglass lenses
    • In-Network: $0 copay (Limits Apply)
  • Eyeglasses (frames and lenses)
    • In-Network: $0 copay (Limits Apply)

Wellness programs (e.g., fitness, nursing hotline)

    • Covered

Advantage Plus

Comprehensive Dental

  • Restorative Services, Endodontics, Periodontics, Prosthodontics, removable, Implant Services, Prosthodontics, fixed, Oral and Maxillofacial Surgery, Orthodontics, Adjunctive General Services
    • Monthly Premium: $12.00

Diagnostic and Preventive Dental

  • Dental X-Rays
    • Monthly Premium: $12.00

Hearing Aids

  • Prescription Hearing Aids (all types)
    • Monthly Premium: $12.00

Hearing Exams

  • Fitting/Evaluation for Hearing Aid
    • Monthly Premium: $12.00

Ready to sign up for Kaiser Permanente Senior Advantage Care Plus (HMO-POS) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 / TTY 711.

M-F: 8:00 am – 10:00 pm EST

Sat-Sun: 8:00 am – 9:00 pm EST

Need more information on Kaiser Permanente Senior Advantage Care Plus (HMO-POS)? See 2025 Kaiser Permanente Senior Advantage Care Plus (HMO-POS) at MedicareAdvantageRX.com.

Table of Contents

Get Help Enrolling

Get help enrolling in a Medicare Advantage or Medicare Prescription Drug Plan by calling a licensed insurance agent today.

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Anthem Blue Cross, Aspire Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, GlobalHealth, Health Care Service Corporation, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Baylor Scott & White Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint

SMID: MULTIPLAN_HCIHNDOGMED01PY25_M

Factsonmedicare.com is a free-to-use informational website by Dog Media Solutions LLC. All insurance agents and enrollment platforms linked to this site have their own terms and conditions.

Medicare has neither approved nor endorsed any information on this site.

This is a promotional communication.

Every year, Medicare evaluates plans based on a 5-star rating system.

Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.

All plan-related information on this site is from CMS.gov and Medicare.gov. We only use data released publicly each year. While our goal is always to provide fact-based, accurate information, information is subject to change, and some data may be inaccurate. Contact a plan for a Summary of Benefits.

Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period.

We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.

We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan’s contract renewal.

Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.

© All rights reserved | About | Contact | Legal and Privacy