Kaiser Permanente also known as Kaiser Foundation Health Plan, name varies from location to location. It is one of the biggest non-profit organizations serving multiple health plans according to region.
It was founded in 1945 in Oakland, California where it serves in eight states including:
- California
- Colorado
- Georgia
- Hawaii
- Maryland
- Oregon
- Virginia
- Washington
It is considered to be one of the best health insurance companies according to analysis where it serves the most speedy recovery and quick diagnosis. Health organizations provide the experts and the best medical providers to treat and care for patients.
There are several types of health insurance provided by Kaiser Permanente Medicare and we are here to discuss it in detail.
What are the types of health insurance provided by Kaiser Permanente Medicare?
There are main 4 types of health insurance plans that are provided by Kaiser Permanente Medicare, and that cover most of the health-related treatments and plans for everyone.
- Family and individual health insurance takes responsibility for each disease that occurs to any family member.
- Medicaid health insurance plans for individual
- Medicare plans for registered insurance
- Employee health insurance plans that are sponsored by each employee of the company
Types of Health Plans Available By Kaiser Permanente
Kaiser Permanente Medicare includes health plans available. There are main two types of plans, that are included in Kaiser Permanente Medicare. It surely differs from region to region.
HMO (Health Maintenance Organisation):
HMO is health insurance that includes a network of physicians specialists and organizations.
Patients who are included in HMO plans are covered by providers who are included in the network only. Typically from the patient’s network only. In most cases, referral for patients is mostly needed if the treatment requires to see a specialist.
Few steps to avail HMO health insurance plan:
- You can take HMO plans from the marketplace from healthcare.gov
- One can hire a health insurance company to avail of HMO plans
- If employees are working in a company, they can avail through HMO plans if the company provides it.
What are the charges to avail of HMO plans?
The average monthly cost of HMO plans from the marketplace is around $390 to $400 only for single coverage till 30 years old.
- $438 full coverage for 40 year old.
- $613 full coverage for 50 year old.
- $930 full coverage for 60 year old.
A few things will make a difference in charges and those include:
- Location
- Age
- Plan tier (Bronze, Silver, Gold or Platinum)
- Dependents on the plan (such as a spouse and children)
- Tobacco use
EPO (Exclusive Provider Organization):
EPO is considered similar to HMO. This plan covers in provider’s network that covers the health treatment which is included in the plan itself. If you are looking to see a specialist, you do not require any reference.
Like an HMO, an exclusive provider organization also provides full coverage of health insurance and can take the help of EPO’s network. EPO generally collaborates with the larger and more expensive HMO plans and a large number of doctors and hospitals for treatments.
What are the charges of EPO plans?
EPO plans vary from region to region. It is quite similar to HMO plans only but slightly different. It is focused more on providing health treatments to local areas and so the charges depend and vary from area to area.
- EPO plans are right for those patients who are looking for budget-friendly plans.
- Patient treatment can be done with the help of a limited network and providers.
Overall benefits of Kaiser Permanente Medicare Members (Includes all health insurance plans)
Kaiser Permanente Medicare consists of several benefits from the available insurance plans and it is the main reason why Kaiser Permanente is one of the well-known health care insurance availed by most people US.
- It provides free access to the health and wellness application to patients. It includes various types of meditation and mindfulness activities that will help patients to recover and have a stress-free lifestyle.
- The app known as MyStrength app is provided for free which helps in tracking goals of recovering from depression, anxiety, and everything related to mental illness.
- Free access to healthy lifestyle programs with various online tutoring related to mindfulness.
- Free online workout and gym sessions for patients.
PPO Plans (Preferred Provider Organisation)
Preferred organization plans are one of the most common types of health plans provided by Kaiser Permanente Medicare for the employer-sponsored market where it is taken care of by Affordable Care Act plans.
Around 46% of Americans working in an office have secured a health plan enrolled in PPO plans where they can get benefits as an employee.
How does a PPO plan work?
Cost-sharing
Considering cost-sharing, insurance covers the deductible percentage and the remaining cost is supposed to be paid. If the treatment costs more than a particular amount, only an amount is supposed to be paid by patients.
In-network providers and Health Experts
Providers and experts agree to work on discounted rates. For example, if a patient’s X-ray total cost is $105, then considering in-network it is just $60.
Incentives of in-network healthcare providers
Providers and health experts in the network cost incentives in lower costs where referrals have the flexibility to manage their health care without any costs.
Access to specialist
Patients do not need primary care referrals to get access to specialists and get treated under them. Emergencies do not need any authorization but in a few cases or treatments, special authorization is needed.
PPO is one of the easiest health insurers that is easily accessible to patients. It is known for its flexibility and hence, it is availed maximum by everyone.
How Much Does PPO Plans Costs?
| Plan Member Age | Charges for a PPO Plan |
| 0-14 | $306 |
| 18 | $362 |
| 21 | $404 |
| 27 | $423 |
| 30 | $458 |
| 40 | $516 |
| 50 | $721 |
| 60 | $1,095 |
| Couple age 21 | $807 |
Considering the pricing plan individually, it is much costlier than HMO and EPO plans but much more flexible than other health plans.
Conclusion
Kaiser Permanente Medicare plans provide 3 main plans that are HMO, EPO, and PPO. HMOs are one of the cost-effective health care plans and in-network care is provided with referrals.
No matter whether you choose any health care plan, every plan has its benefits and it is highly important for taking health care insurance to avoid extra billing and availing of cost-effective plans.
It will always provide quality health care and treatments where patients get the most of the benefits through a wider range of specialists and health care experts. Avail of suitable plans according to your region, budget, and availability of healthcare plans..
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Frequently Asked Questions
1. Which California health insurance is best?
In 2024, Kaiser Permanente is California’s top health insurer. MoneyGeek analyzes age, MOOP expenses, and plan types to find the best providers for different needs.
2. Is Kaiser exclusive to the state of California?
Kaiser Permanente serves California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, Washington, and Washington, D.C. Kaiser Permanente members receive global emergency and urgent care.
3. Which four health insurance plans are most common?
PPO plan. HMO plan. POS plan. Organization exclusive to one provider
References
ttps://www.investopedia.com/terms/h/hmo.asp
https://www.healthcare.gov/glossary/exclusive-provider-organization-epo-plan
https://healthy.kaiserpermanente.org/shop-plans/ready-for-medicare
https://permanente.org/5-kaiser-permanente-medicare-health-plans-earn-5-stars/
https://www.investopedia.com/terms/p/preferred-provider-organization.asp
