Does Kaiser Accept Medicare? What You Need to Know

Kaiser Permanente and Medicare: The Basic Answer

Yes, Kaiser Permanente accepts Medicare, but not everywhere and not in the same way everywhere it does. Kaiser operates in 8 states and Washington D.C., and Medicare coverage through Kaiser depends on which state you live in and which Kaiser region serves your area. Some regions offer Medicare Advantage plans (also called Medicare Part C), some offer traditional Medicare with a Kaiser supplement, and some offer both. A few Kaiser regions do not work with Medicare at all.

The first step is to find out whether Kaiser in your state actually accepts Medicare. You can do this by calling Kaiser's Medicare line for your region or visiting the Medicare plan finder on Medicare.gov, which shows you every plan available in your zip code.

Key Takeaways

Kaiser accepts Medicare in California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, Washington state, and Washington D.C., but not all Kaiser regions in those states offer Medicare plans.
Most Kaiser Medicare coverage comes through Medicare Advantage plans, which combine Part A, Part B, and usually Part D prescription coverage in one plan.
You can only join a Kaiser Medicare plan during the annual enrollment period (October 15 to December 7) or if you have a may have access to life event.
To confirm Kaiser accepts Medicare in your area, use the Medicare plan finder at Medicare.gov or call Kaiser's Medicare line for your state.

Which Kaiser Regions Offer Medicare Plans

Kaiser Permanente operates in eight states plus Washington D.C. In California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, and Washington, Kaiser offers at least one Medicare plan option. However, coverage varies by region within each state. For example, Kaiser Northern California and Kaiser Southern California both offer Medicare plans, but Kaiser's Colorado region may have different plan types or availability than its Washington state region.

The easiest way to know what Kaiser offers where you live is to enter your zip code into the Medicare plan finder at Medicare.gov. This tool shows every Medicare plan available to you, including Kaiser plans if they exist in your area. You can also call Kaiser directly and ask whether they accept Medicare in your specific location.

Medicare Advantage Plans Through Kaiser

Most people who use Kaiser with Medicare are enrolled in a Medicare Advantage plan (Part C). This is a single plan that combines Medicare Part A (hospital), Part B (doctor visits), and usually Part D (prescription drugs). You pay a monthly premium to Kaiser instead of to Medicare, and Kaiser becomes your main insurance company.

Kaiser Medicare Advantage plans typically include benefits that Original Medicare does not cover, such as dental, vision, hearing, or gym memberships. However, you must use Kaiser doctors and hospitals in your region — you cannot see an out-of-network provider except in emergencies. If you travel outside your Kaiser region regularly, this can be a problem.

Each Kaiser Medicare Advantage plan has its own deductible, copay amounts, and out-of-pocket maximum. These change every year. You should review your plan's details during the annual enrollment period to see whether the costs and benefits still match your needs.

Medigap Supplement Plans and Kaiser

Some Kaiser regions also offer Medigap (supplemental insurance) plans that work alongside Original Medicare. With this option, you keep your Original Medicare coverage and add a Kaiser Medigap plan to cover costs that Medicare does not pay, such as copays and coinsurance.

Medigap through Kaiser is less common than Medicare Advantage through Kaiser, and availability depends on your state and region. If you want to use Original Medicare with a Kaiser supplement, ask Kaiser directly whether this option exists in your area. You can also contact Medicare at 1-800-MEDICARE to confirm what plans are available to you.

When You Can Enroll in Kaiser Medicare Plans

You can join a Kaiser Medicare plan only during specific times. The main enrollment window is the annual enrollment period, which runs from October 15 to December 7 each year. Plans you choose during this period start on January 1 of the following year.

You can also join a Kaiser Medicare plan outside the annual period if you have a may have access to life event. These include turning 65, losing other health coverage, moving to a new state, or getting married or divorced. When a may have access to event happens, you usually have 60 days to join a plan. If you miss this window, you may have to wait until the next annual enrollment period.

What to Ask Kaiser Before You Enroll

Before you choose a Kaiser Medicare plan, ask these questions to make sure it fits your situation:

Does this plan cover my current doctors and the hospitals I use?
What is the monthly premium, deductible, and out-of-pocket maximum for this plan?
Does this plan cover my prescription drugs, and what is the cost?
If I travel outside the Kaiser service area, what coverage do I have?
Can I switch to a different Kaiser plan or to Original Medicare next year if I change my mind?
Does this plan include dental, vision, or hearing coverage?

You can ask these questions by calling Kaiser's Medicare line, visiting a Kaiser office, or reviewing the plan documents on Medicare.gov.

When to Contact Kaiser or Medicare

Contact Kaiser directly if you want to know whether they accept Medicare in your zip code, what plans they offer, or what your costs would be under a specific plan. Kaiser's phone number varies by state, but you can find it by searching "Kaiser Medicare [your state]" or by calling 1-800-MEDICARE and asking for a referral.

Contact Medicare at 1-800-MEDICARE if you want to compare all Medicare plans available to you, not just Kaiser plans. Medicare staff can also answer questions about how Medicare Advantage and Medigap work, and they can help you understand your coverage options.

Seek care when ready if you are already enrolled in a Kaiser Medicare plan and you have a medical emergency. Call 911 or go to the nearest emergency room. Kaiser Medicare Advantage plans cover emergency care even outside the Kaiser network.

Frequently Asked Questions

Can I use my Kaiser Medicare plan if I move to a different state?

No. Kaiser Medicare plans are tied to the region where you enroll. If you move to a state where Kaiser does not operate, or to a Kaiser region that does not cover your new address, your plan will end. You will need to join a different Medicare plan in your new location. Contact Medicare.gov or call 1-800-MEDICARE to find plans available in your new zip code.

What happens to my Kaiser Medicare plan if I go back to Original Medicare?

You can switch from a Kaiser Medicare Advantage plan to Original Medicare during the annual enrollment period or if you have a may have access to life event. Once you switch, your Kaiser plan ends. If you want a supplement to cover costs that Original Medicare does not pay, you can purchase a Medigap plan from any insurance company, not just Kaiser.

Does Kaiser Medicare cover out-of-network doctors?

Kaiser Medicare Advantage plans generally do not cover out-of-network care except in emergencies. If you need a specialist or routine care, you must use a Kaiser doctor or hospital in your region. Some Kaiser plans may cover out-of-network urgent care in limited situations — check your plan documents or call Kaiser to confirm.

How do I know if Kaiser is in my area?

Enter your zip code into the Medicare plan finder at Medicare.gov. If Kaiser plans appear in the results, Kaiser operates in your area. You can also call Kaiser directly or call 1-800-MEDICARE and ask whether Kaiser accepts Medicare where you live.

What is the difference between a Kaiser Medicare Advantage plan and a Kaiser Medigap plan?

A Medicare Advantage plan replaces Original Medicare and is your main insurance. A Medigap plan works alongside Original Medicare to cover costs that Medicare does not pay. Medicare Advantage plans often include extra benefits like dental or vision. Medigap plans do not include those extras but give you more flexibility to see any doctor who accepts Medicare.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.