The Kaiser Permanente Senior Advantage Choice PPO plan: Flexibility with access to high-quality, convenient, and connected care for Medicare beneficiaries.
DENVER — Kaiser Permanente — Colorado’s leading nonprofit health plan and one of the state’s largest health care providers — launched the Kaiser Permanente Senior Advantage Choice preferred provider organization plan on October 16, 2023. The plan provides individual Medicare members access to Kaiser Permanente’s high-quality integrated care model and the flexibility to see other providers. This new product broadens Kaiser Permanente’s Medicare health plan offerings, which still include the HMO option.
The Senior Advantage Choice PPO plan is available during the annual enrollment period, between October 15 and December 7, 2023, with a January 1, 2024, effective date. Additionally, individuals who are new to Medicare, who moved, or who lost coverage and live in the Senior Advantage Choice PPO service area can enroll.
The Choice PPO is an all-in-one solution for Colorado Medicare beneficiaries who are interested in accessing Kaiser Permanente’s nationally recognized integrated health care model (see note below), a broad network of providers nationally, and the flexibility to access any provider that accepts Medicare on an out-of-network basis. The Choice PPO offers access to hospitals and health systems in Colorado and urgent and emergency care anywhere in the world.
“Today’s Medicare beneficiaries are more active than they’ve ever been, and they need options to meet their health care needs without having to put their lives on hold,” said Mike Ramseier, regional president for Kaiser Permanente in Colorado. “Our new Senior Advantage Choice PPO gives Medicare members the flexibility to get care from network and out-of-network providers both here in Colorado and anywhere across the country.”
The new plan offers Medicare members the integrated care Kaiser Permanente is recognized for, along with the flexibility to meet their needs in the moment. “Our outcomes prove that Medicare members benefit from the way Kaiser Permanente primary care and specialty care teams work together to ensure patients receive high-quality, evidence-based care,” said Jeff Krawcek, MD, executive medical director of Kaiser Permanente in Colorado. “By expanding access through our Senior Advantage Choice PPO, we are ensuring Medicare members can get the care they need, when they need it, wherever they are, with network partners held to the same high-quality standards.”
Regardless of the prescribing provider, Choice PPO plan members can fill prescriptions at any Kaiser Permanente pharmacy. They can also use Kaiser Permanente’s mail-order services. Members can also fill prescriptions at most pharmacies across the country, including King Soopers, Walgreens, CVS, Safeway, and Costco. Members may have lower copays, deductibles, and other costs using Kaiser Permanente pharmacies — especially with the convenient mail-order service.
The new Senior Advantage Choice PPO plan has a $0 premium, $0 in-network copays for primary care visits, $0 Tier 1 generic medications, and more. The plan includes extra benefits, including dental, fitness, vision, hearing, transportation to medical appointments, and an over-the-counter allowance. The dental benefit includes $0 copays for preventive care and an allowance for comprehensive care, including fillings, periodontics, and root canals. The plan includes a flexible allowance for vision and hearing hardware. In addition, the Choice PPO includes SilverSneakers®, giving members unlimited access to thousands of gyms and fitness centers across the country.
Members of the new plan have access to kp.org, where they can refill prescriptions, schedule appointments, view their visit history, and more.
Individuals who are new to Medicare, moved, or lost coverage and live in the following counties are eligible to enroll in the Senior Advantage Choice PPO plan:
Learn more about Medicare and Kaiser Permanente at kp.org, or call 1-855-817-5826 (TTY 711), from 8 a.m. to 8 p.m., Monday through Friday, or contact a Medicare broker.
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 12.6 million commercial and Medicare members in 8 states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists, and team of caregivers. Our caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, care delivery, and chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education, and the support of community health.
Note: Kaiser Foundation Health Plan of Colorado is the top-rated HMO in Colorado, with a rating of 4.5 out of 5 in NCQA’s Medicare Health Plan Ratings 2023. NCQA’s Medicare Health Insurance Plan Ratings 2023-2024, National Committee for Quality Assurance, 2023: Kaiser Foundation Health Plan of Colorado — HMO (rated 4.5 out of 5).
Kaiser Permanente is a PPO plan with a Medicare contract. Enrollment in Kaiser Permanente depends on contract renewal.
For certain drugs, you can get prescription refills mailed to you through our Kaiser Permanente mail-order pharmacy. You should receive them within 3 to 5 days. If not, please call 1-866-523-6059 (TTY 711).
Kaiser Permanente’s pharmacy network includes limited lower-cost, preferred pharmacies in Colorado. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, please call 1-800-476-2167 (TTY 711), 7 days a week, 8 a.m. to 8 p.m., or consult the online pharmacy directory at kp.org/directory.
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CMS filing number: H3138_24040_M