Yes, Kaiser Permanente accepts Medicare, but coverage depends on which Kaiser plan you choose

Kaiser Permanente is a large health insurance company that works with Medicare in most states where it operates. However, not every Kaiser plan accepts Medicare, and the coverage you get varies by location and plan type. If you are turning 65 or already on Medicare, you have options within Kaiser — but you need to know which ones are available where you live and what each one covers.

Kaiser offers three main ways to use Medicare with them: a Medicare Advantage plan (also called Part C), a Medigap supplemental plan paired with Original Medicare, or enrollment in their HMO if you live in a Kaiser service area and have both Medicare Part A and Part B. Each route works differently, covers different services, and has different costs.

Key Takeaways

  • Kaiser Medicare Advantage plans are available in select states and counties, so you must check whether Kaiser offers Part C coverage in your zip code.
  • Kaiser also sells Medigap plans (supplemental insurance) that work alongside Original Medicare Parts A and B if you prefer not to switch to Medicare Advantage.
  • If you are already a Kaiser member with employer coverage, you can usually keep Kaiser when you turn 65 by switching to a Medicare plan.
  • Kaiser's service area is limited — the company does not operate nationwide, so availability depends entirely on where you live.
  • You must have Medicare Part A and Part B before you can join any Kaiser Medicare plan, whether Advantage or Medigap.

Kaiser Medicare Advantage plans and what they cover

Kaiser's Medicare Advantage plans (Part C) bundle your hospital coverage (Part A), doctor visits (Part B), and prescription drugs (Part D) into one plan. You pay a monthly premium to Kaiser instead of to Medicare, and Kaiser handles all the claims. Most Kaiser Advantage plans have low or zero monthly premiums, but you pay copays when you use services — typically $10 to $50 per doctor visit, depending on the plan.

Kaiser Advantage plans include prescription drug coverage built in, so you do not need to buy Part D separately. They also often cover dental, vision, and hearing services that Original Medicare does not pay for. However, you must use Kaiser doctors and hospitals — if you go outside the Kaiser network, you usually pay much more or the plan does not cover it at all. This matters if you travel frequently or live part of the year in another state.

Kaiser Medicare Advantage plans are not available everywhere. You can only join one if Kaiser operates in your county and offers Part C plans there. To find out whether Kaiser has Advantage plans in your area, visit Medicare.gov, use the plan finder tool, or call Kaiser directly at the number on your Medicare card or the Kaiser website for your state.

Kaiser Medigap plans paired with Original Medicare

If you want to keep Original Medicare (Parts A and B) but add coverage for costs that Medicare does not pay, Kaiser sells Medigap supplemental plans in some states. A Medigap plan covers things like copays, coinsurance, and deductibles that come out of your pocket under Original Medicare. You keep your Medicare card, see any doctor or hospital that accepts Medicare, and Kaiser's Medigap plan pays the gaps.

Medigap plans have their own monthly premiums, separate from your Medicare Part B premium. The cost varies by plan type and your age, and it usually increases each year. Unlike Medicare Advantage, Medigap plans do not include prescription drug coverage, so you must sign up for Part D separately through Medicare or another insurance company.

Kaiser Medigap availability is limited. Not all states where Kaiser operates offer Medigap plans, and not all Medigap plan types (A through N) are available in every location. You can see which Medigap plans Kaiser offers in your state by visiting the Kaiser website or calling their Medicare sales line.

Switching from employer coverage to Kaiser Medicare

If you are currently covered by Kaiser through an employer and you turn 65, you do not automatically lose coverage. Instead, you become may be able to access for Medicare, and you can switch your Kaiser plan to a Medicare plan — either Advantage or Medigap, depending on what Kaiser offers in your area. Your employer coverage ends, but Kaiser coverage does not have to.

You must enroll in Medicare Part A and Part B during your Initial Enrollment Period, which starts three months before the month you turn 65 and ends three months after. If you miss this window, you may pay a penalty for the rest of your life. Once you have Part A and Part B, you can then join a Kaiser Medicare plan during the Annual Enrollment Period (October 15 to December 7 each year) or during a Special Enrollment Period if you may have access to.

Contact Kaiser's Medicare team before your 65th birthday to understand your options. They can tell you which Medicare plans Kaiser offers in your area and help you understand the switch from employer coverage to Medicare.

Kaiser service areas and where Medicare plans are available

Kaiser operates in California, Colorado, Georgia, Hawaii, Idaho, Oregon, Texas, Virginia, and Washington, plus Washington D.C. However, Kaiser does not serve all counties in these states, and Medicare plan availability varies even within states where Kaiser operates. For example, Kaiser may offer Medicare Advantage in one county but not in the next county over.

Before you assume Kaiser Medicare is available to you, check your specific zip code on Medicare.gov or call Kaiser. If Kaiser does not serve your area, you will need to choose a different Medicare plan — either Original Medicare with a Medigap plan from another company, or a Medicare Advantage plan from a different insurer.

Costs: premiums, copays, and deductibles

Kaiser Medicare Advantage plan premiums vary by plan and location. Many Kaiser Advantage plans have $0 monthly premiums, meaning you pay nothing extra beyond your Part B premium to Medicare. However, you pay copays when you use services — doctor visits, specialist visits, emergency room, hospital stays, and prescriptions all have copay amounts set by your specific plan.

Kaiser Medigap plans have monthly premiums that vary by plan type and your age. Unlike Advantage plans, Medigap plans typically have no copays — the plan pays the gaps in Original Medicare coverage. However, you still pay the Part B deductible (which changes each year) before Medigap kicks in, unless you choose a plan that covers the deductible.

Costs change every year. Kaiser sends notices in the fall about premium and copay changes for the next year. You can review these changes during the Annual Enrollment Period and switch plans if a different option costs less or covers what you need better.

What to ask Kaiser before you enroll

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

  • Does Kaiser offer Medicare plans in my zip code, and which types (Advantage or Medigap)?
  • If I choose Advantage, which doctors and hospitals are in the Kaiser network near me?
  • What are the copays for the services I use most — doctor visits, specialists, prescriptions?
  • If I travel or spend time in another state, will my plan cover care outside the Kaiser network?
  • Does the plan cover the prescription drugs I take, and are there any restrictions?
  • What is the total out-of-pocket maximum for the year, and what does it include?
  • If I choose Medigap, which plan types does Kaiser offer, and what is the monthly premium for each?

When to contact Kaiser about Medicare

Contact Kaiser at least three months before you turn 65 or before your Medicare coverage begins. This gives you time to understand your options, ask questions, and enroll during the right period. If you are already a Kaiser member, you can call the number on your current Kaiser card and ask to speak with someone in Medicare enrollment.

If you are new to Kaiser and Medicare, visit the Kaiser website for your state and look for the Medicare section, or call Kaiser's Medicare sales line. Have your Social Security number and the date you want coverage to start ready when you call.

Frequently Asked Questions

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

No. Kaiser Medicare Advantage plans only work in the counties where Kaiser operates. If you move out of a Kaiser service area, your plan ends, and you must choose a new Medicare plan in your new state. If you spend part of the year in another state, ask Kaiser whether your plan covers emergency or urgent care outside the network.

Do I have to use Kaiser doctors if I have a Kaiser Medicare plan?

With Kaiser Medicare Advantage, yes — you must use Kaiser doctors and hospitals for routine care, or you pay much more. With Kaiser Medigap paired with Original Medicare, no — you can see any doctor or hospital that accepts Medicare, and your Medigap plan covers the gaps.

What happens to my Kaiser coverage when I turn 65?

Your current Kaiser employer plan ends when you become may be able to access for Medicare. You must enroll in Medicare Part A and Part B, then you can switch to a Kaiser Medicare plan if one is available in your area. Contact Kaiser before your 65th birthday to start the process.

Can I switch from Kaiser Medicare Advantage to Medigap later?

Yes, but timing matters. You can switch during the Annual Enrollment Period (October 15 to December 7) without penalty. If you switch at other times, some Medigap plans may deny you or charge more based on your health. Talk to Kaiser about the best time to switch based on your situation.

What if Kaiser does not offer Medicare plans in my area?

You will need to choose a different Medicare plan. You can enroll in Original Medicare (Parts A and B) and buy a Medigap plan from another insurance company, or choose a Medicare Advantage plan from a different insurer. Use Medicare.gov's plan finder to see what is available in your zip code.