{"id":11730,"date":"2024-05-22T08:08:25","date_gmt":"2024-05-22T08:08:25","guid":{"rendered":"https:\/\/distilinfo.com\/healthplan\/?p=11730"},"modified":"2024-05-28T07:56:32","modified_gmt":"2024-05-28T07:56:32","slug":"kaiser-permanente-vs-bcbs","status":"publish","type":"post","link":"https:\/\/distilinfo.com\/healthplan\/kaiser-permanente-vs-bcbs\/","title":{"rendered":"Kaiser Permanente vs. BCBS | Medicare Advantage Comparison"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Kaiser Permanente is an American integrated care consortium based in Oakland, California, United States. Henry J. Kaiser and Sidney Garfield were responsible for founding it in 1945.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Kaiser Permanente almost operates around 39 hospitals and around 700 medical offices. Talking about the organization, consists of over 300,000 personnel. There are around 87k physicians and nurses.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Blue Cross Blue Shield Association (BCBS, BCBSA) is a United States-based federation with around 34 independent companies. It provides health insurance in the USA for more than 115 million people.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">It communicates with members and other operation policies that need licenses and trademarks. It operates in designated areas where it claims reimbursement programs to different sectors.\u00a0<\/span><\/p>\n<h2><b>Brief about Kaiser and Blue Cross Shield Plans<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Kaiser Permanente provides Medicare Advantage Plans. It has eight dedicated states around Washington, DC. They use one integrated care model where everyone can combine work without any miscommunication happening. They can be connected all the time.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Considering Blue Cross Shield, it is a group of 33 companies. Each company of Blue Cross provides different services according to the local needs that are tailored to local members.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Let\u2019s get into detail about the advantages of the plans for Kaiser Permanente vs. Blue Cross Blue Shield.<\/span><\/p>\n<h3><b>General Kaiser Permanente Medicare Advantage<\/b><\/h3>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Kaiser Permanente plans are rated below average because they are limited to selling only in eight Washington, D.C.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">J.D. Power has found that it earns above-average satisfaction in California Medicare markets.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Most of the plans have drug coverage, which helps drug addicts stop drug consumption.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Among the 10 people, there are 8 members with highly-rated plans.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">It is 5th largest Medicare Advantage provider plan<\/span><\/li>\n<\/ul>\n<h2><b>Medicare Plan Advantage Options\u00a0<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">The medicare plan advantage options depend on the region that you live in. You can leverage different plans according to the region and go through what suits you the best. Let\u2019s get into each plan&#8217;s benefits.\u00a0<\/span><\/p>\n<h3><b>Kaiser HMO Plans<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Kaiser\u2019s HMO (Health Maintenance Organization) plans are for those who have in-network physicians. When a patient gets ill, the provider will be right there as a prevention source and for the medical attention that is needed as per the requirement. Not only that, but even special care is provided if the condition is critical, and they can also refer to their in-network specialist.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Apart from these basic services, they provide a few additional services and different membership programs, such as SilverSneakers. They provide memberships to use the gym facilities and other fitness and wellness programs you need.<\/span><\/p>\n<h3><b>Kaiser\u2019s PPO Plan<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">Kaiser\u2019s PPO (Preferred Provider Organization) plan often separates the cost of seeing providers into two tiers. There are two models: one is a \u201cparticipating provider,\u201d which has lower and more affordable costs, and the second is a \u201cnon-participating provider,\u201d which you can access as a licensed provider only.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">When compared, the PPO plan is different from the HMO plan, as you will need a referral to see its specialty. Talking about Kaiser\u2019s plan, you will need pre-certification before you avail of a few of the surgeries, radiology, or any complex lab reports or work.<\/span><\/p>\n<h3><b>Kaiser Part D Plans<\/b><span style=\"font-weight: 400;\">\u00a0<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Most of the Kaiser Medicare Advantage plans include drug program coverage but there is also a separate plan available by Kaiser. The prescription of Kaiser plan D is available in three tiers, categorized in different price ranges.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Low- or generic-tier plan: It is the least expensive and most affordable plan, while premium plans include expensive drugs and some high-level treatments. If you are looking for a cost-saving hack, then it is always suggested that you join the affiliated Kaiser\u2019s mail-order pharmacy programs.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Talking about special healthcare needs and treatments includes a few of the diseases and conditions that include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Chronic conditions<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Institutional special needs\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Dual-eligible SNPs for Medicare and medical coverage programs<\/span><\/li>\n<\/ul>\n<h3><b>States that are eligible for the Kaiser\u2019s Medicare Advantage Plans:<\/b><\/h3>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">California\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Colorado\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Georgia\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Hawaii<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Maryland<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Oregon<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Virginia<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Washington DC<\/span><\/li>\n<\/ul>\n<h3><b>Kaiser\u2019s Medicare Plan Coverage<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">There are different plan coverage and advantages that patients can leverage according to the region they live in. However, some plans can be included.\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">You can leverage all the benefits of the Kaiser Medicare Advantage plan.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The preventive care services include free or low-cost check-ups like normal reports checking blood pressure, cholesterol, or cancer screenings up to a limited age.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Kaiser provides hearing and vision services that include an examination every year to check the well-being of the routine. However, other related exams for hearing and eyesight come under the Advantage Plus plan.\u00a0<\/span><\/li>\n<\/ul>\n<h2><b>A brief introduction to Blue Cross Shield Medicare<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Health insurance plans in the United States adopted the name &#8220;Blue Cross.&#8221; Justin Ford Kimball created it in 1929.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Employees in lumber and mining camps developed Blue Shield of the Pacific Northwest. It provided medical care with nominal monthly charges. Later, nine medical plans were associated with medical care plans and were renamed the National Association Of Blue Shield Plans.\u00a0<\/span><\/p>\n<h3><b>Blue Shield Plans and its Advantages<\/b><\/h3>\n<p><span style=\"font-weight: 400;\">HMOs and PPOs are two of the cost-saving options, along with the original Medicare benefits.\u00a0<\/span><\/p>\n<h3><b>Advantages of HMO Medicare Plans (Blue Cross)<\/b><\/h3>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">There is a lower-cost premium or absolutely no monthly premium charge<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">There is one primary care provider who will know your medical history. It helps a lot while treating the patients and providing accurate medication accordingly.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">No referral is required from a primary care physician before visiting.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The Blue Shield HMO plans may or may not cover drug prescriptions.<\/span><\/li>\n<\/ul>\n<h3><b>Advantages of PPO Blue Cross Medicare<\/b><\/h3>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">It has higher monthly premium plans<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The patient does not need a PCP plan selection<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Patients can take advantage of doctors, healthcare, and hospitals outside of the network but need to pay the coinsurance.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">If patients do not want to pay for coinsurance, they can opt for doctors and healthcare providers within the network that are included in the plan under Blue Shield Medicare Plans.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Blue Cross Medicare Advantage plan is for one full year. If the plan is carried forward for the following year, determination will be carried forward. The patient will not lose Medicare coverage if the medicare plan is not available next year.<\/span><\/p>\n<h2><b>How to Find the Right Medicare Advantage Plan?<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">When you are planning to avail of any <\/span><a href=\"https:\/\/www.nerdwallet.com\/article\/insurance\/medicare\/medicare-advantage-plans-how-to-compare\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Medicare Advantage plans<\/span><\/a><span style=\"font-weight: 400;\">, it is important to research the basic requirements we have gathered some of the commonly asked questions before knowing or availing of any Medicare plans.<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">What are Medicare Plans\u2019 costs?<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Is the doctor included in the network of the medical plan?<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Know if there is any dental coverage included<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ask if there are any extra services included with benefits for you as patients.<\/span><\/li>\n<\/ul>\n<h2><b>Choose The Appropriate Medicare Plan For Your Need<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">When you choose between <\/span><span style=\"font-weight: 400;\">Kaiser Permanente vs. Blue Cross Blue Shield<\/span><span style=\"font-weight: 400;\">, you must know your needs as both offer different Medicare advantages. Kaiser offers all the medicated care with the providers connected whereas BCBS has flexible plans that can be customized according to the local needs and that include both, in and out-network care.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">When you tend to choose one of the plans, it also becomes important to know the basic advantages that you as a patient can get out of it.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Consider your location,\u00a0 health requirements, and preferred treatments when needed, this classification will help you to decide to choose one of the plans.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">For more updates on <\/span><b>health trends<\/b><span style=\"font-weight: 400;\">, <\/span><b>medical advancements<\/b><span style=\"font-weight: 400;\">, and <\/span><b>payer news<\/b><span style=\"font-weight: 400;\"> subscribe to <\/span><a href=\"https:\/\/distilinfo.com\/healthplan\/\"><span style=\"font-weight: 400;\">DistilInfo HealthPlan<\/span><\/a><span style=\"font-weight: 400;\"> and stay ahead in the ever-changing healthcare industry. Follow us for regular updates and valuable industry insights.<\/span><\/p>\n<h2><b>Frequently Asked Questions<\/b><\/h2>\n<p><b>1. Which is the best health insurance provider?<\/b><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0Kaiser Permanente is the finest overall health insurer due to its affordable and high-rated policies. If Kaiser is unavailable, Blue Cross Blue Shield is a good health insurance carrier with more coverage options<\/span><\/p>\n<p><b>2. How many hospitals does Kaiser have in the United States?<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Kaiser Permanente is a significant nonprofit health plan in America. More than 24,605 Permanente Medical Group physicians, 73,618 nurses, and 75,000 allied health workers in 40 hospitals and 618 medical institutions are paid for by our health plan.<\/span><\/p>\n<p><b>3. Which California health insurers are the largest?<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Kaiser, Anthem Blue Cross, Blue Shield of California, Health Net, Aetna, United (group), and AARP (Senior) are California&#8217;s leading carriers, depending on the market sector.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Kaiser Permanente is an American integrated care consortium based in Oakland, California, United States. Henry J. Kaiser and Sidney Garfield&#8230; <a href=\"https:\/\/distilinfo.com\/healthplan\/kaiser-permanente-vs-bcbs\/\" style=\"white-space: nowrap;\">Continue Reading <i class=\"fas fa-long-arrow-alt-right\" style=\"vertical-align: middle;\"><\/i><\/a><\/p>\n","protected":false},"author":1,"featured_media":11731,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[1],"tags":[227,125],"_links":{"self":[{"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/posts\/11730"}],"collection":[{"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/comments?post=11730"}],"version-history":[{"count":3,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/posts\/11730\/revisions"}],"predecessor-version":[{"id":11814,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/posts\/11730\/revisions\/11814"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/media\/11731"}],"wp:attachment":[{"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/media?parent=11730"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/categories?post=11730"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/tags?post=11730"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}