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Healthy Extras

Healthy extras

NEW FOR 2022

Medicare Explorer by Kaiser Permanente1

Travel with peace of mind knowing that Kaiser Permanente Medicare Advantage (HMO) plans include a $1200 annual allowance for out-of-area routine and continuing care such as office visits, labs, X-rays, physical therapy, and outpatient mental health care. With low and predictable costs, you’ll have easy access to care while traveling. For the best experience, see any provider that accepts Medicare in the United States and its territories. You do not need a referral or pre-authorization for covered services. To find a provider that accepts Medicare, visit medicare.gov.

The Medicare Explorer allowance can only be used outside of Kaiser Permanente service areas, which includes all or parts of Maryland, Virginia, Washington, DC, California, Colorado, Georgia, Hawaii, Oregon, and Washington. To confirm that the area where you are traveling is covered by this benefit, call Member Services at 1-888-777-5536​ (TTY 711), 8 a.m. to 8 p.m., 7 days a week.

 

Covered Service

Copay

Preventive care

$0 per visit

Primary care office visits

$20 per visit

Specialty care office visits

$50 per visit

Labs

$10

X-rays ​

$25

Physical therapy

$50

Mental Health Care

Individual visits

Group visits

$25 per individual visit

$15 per group visit

Part B clinically administered drugs

20% coinsurance

See the Evidence of Coverage for additional details and excluded services at kp.org/eocmasma.

Hearing aid allowance2

Enhance your total health with hearing aids from Kaiser Permanente. Our health plans include a $500 hearing aid allowance per ear, every 36 months, as well as coverage for hearing exams, to use at Kaiser Permanente audiology centers. You’ll also receive the added value of follow-up care, a warranty for repairs, and a low replacement fee for lost hearing aids. And hearing aid models offered by Kaiser Permanente are often priced 25-40% less than those at other hearing centers in the DC metro region.3 You’ll also be receiving care from highly skilled audiologists, all with doctorates in audiology.

Hearing aids purchased from Kaiser Permanente include:

• 3-year warranty for repair
• 3-year warranty for loss and damage with a one-time $250 replacement fee per hearing aid
• Follow-up appointments for programming adjustments for 3 years

To learn more and find a Kaiser Permanente audiology center, visit kp.org/hearingcare or call 1-703-359-7878​ to schedule a hearing aid consultation.

 

Over-the-counter (OTC) wellness credit4

Our Kaiser Permanente Medicare Advantage (HMO) plans include a quarterly allowance that can be used to purchase items such as:

Vitamins and minerals

Allergy, cough, and cold remedies

Antacids, laxatives, and stomach aids

Pain relievers and fever reducers

First aid kits, joint supports, and incontinence products

Blood pressure monitors and thermometers

Diabetic supplies such as compression stockings and sharps containers

The OTC wellness credit quarterly amount is based on your plan type.

To order, visit kp.org/otc/mas​ or call 1-833-881-1422, Monday through Friday, 8 a.m. to 7 p.m.

PLAN

OTC WELLNESS CREDIT QUARTERLY ALLOWANCE

Kaiser Permanente Medicare Advantage Value plans

$30

Kaiser Permanente Medicare Advantage Standard plans

$50

Kaiser Permanente Medicare Advantage High plans

$60

Vision

Your plan includes routine eye exams, glaucoma screenings, and cataract screenings at Vision Essentials locations in our medical centers. You also receive an allowance on glasses or contact lenses. Your copay amounts and eyewear allowance are based on your plan type.

PLAN TYPE

ROUTINE EYE EXAMS

EYEWEAR ALLOWANCE

MARYLAND

Kaiser Permanente Medicare Advantage Value Balt and MD plans

$10 per visit with an optometrist

$50 per visit with an ophthalmologist

$200 every 24 months

Kaiser Permanente Medicare Advantage Standard plan

$10 per visit with an optometrist

$40 per visit with an ophthalmologist

$200 every 24 months

Kaiser Permanente Medicare Advantage High plan

$5 per visit with an optometrist

$30 per visit with an ophthalmologist

$225 every 24 months

VIRGINIA

Kaiser Permanente Medicare Advantage Value plan

$10 per visit with an optometrist

$45 per visit with an ophthalmologist

$200 every 24 months

Kaiser Permanente Medicare Advantage Standard plan

$5 per visit with an optometrist

$35 per visit with an ophthalmologist

$250 every 24 months

Kaiser Permanente Medicare Advantage High plan

$5 per visit with an optometrist

$30 per visit with an ophthalmologist

$250 every 24 months

DISTRICT OF COLUMBIA

Kaiser Permanente Medicare Advantage Value plan

$10 per visit with an optometrist

$50 per visit with an ophthalmologist

$200 every 24 months

Kaiser Permanente Medicare Advantage Standard plan

$10 per visit with an optometrist

$40 per visit with an ophthalmologist

$250 every 24 months

Kaiser Permanente Medicare Advantage High plan

$5 per visit with an optometrist

$30 per visit with an ophthalmologist

$250 every 24 months

MARYLAND, VIRGINIA, & WASHINGTON, DC

Kaiser Permanente Medicare Advantage Liberty plan
without Part D (HMO)

$10 per visit with an optometrist

$35 per visit with an ophthalmologist

$200 every 24 months

​ Silver&Fit fitness program

The Silver&Fit fitness program,5​ which is included in your Kaiser Permanente Medicare Advantage (HMO) plan, helps you get and stay active—at no additional cost.

Your plan includes:
  • Fitness center membership—reshape your life with membership at a local participating Silver&Fit fitness center. Visit SilverandFit.comto find a fitness center near you. ​ ​ ​
  • Digital fitness choices with home fitness tools—Members may select one6​ Home Fitness Kit per calendar year. Choose from Wearable Fitness Tracker, Pilates, Strength, Swim, and Yoga Kit options. This benefit also includes access to digital workout videos, The Get Started Program, Healthy Aging educational materials, newsletters, online classes, and other helpful features.
Choose one of these options:
  • Fitness center membership—reshape your life with membership at a local participating Silver&Fit fitness center. Visit SilverandFit.comto find a fitness center near you. ​ ​ ​
  • Home fitness program—Prefer to workout at home? Choose the home fitness program and receive up to two fitness kits2​ per contract year that may include a DVD, instructional booklet, and quick start guide.
Examples of home fitness programs include:
  • Fitbit Connected!—receive a promotional code valued at $50 toward the purchase of a Fitbit
  • Tai chi
  • Barre fitness
  • Yoga
Additional features include:
  • Healthy aging educational materials on DVD and through the Silver&Fit website
  • Quarterly health newsletter
  • The Silver&Fit Connected!™ tool, a fun and easy way to track your exercise at a fitness center or through a wearable fitness device or app and earn rewards7

Transportation for nonemergency medical appointments

Now it’s even easier to access care. Kaiser Permanente Medicare Advantage includes 24 rides8​ for nonemergency medical appointments at Kaiser Permanente medical centers and contracted facilities. Never miss an important medical appointment—one of the many ways we help you thrive.

Preventive Dental Plan

When you enroll in a Kaiser Permanente Medicare health plan, you automatically receive preventive dental coverage through Dominion National (Dominion). With the Preventive Dental Plan, you pay a $30 copayment for each preventive care office visit.

This includes:

• Oral exams, up to two per year

• Cleanings, up to two per year

• Bitewing X-rays, up to two per year

More extensive care (fillings, crowns, dentures, root canals, periodontal treatment, oral surgery, etc.) is provided at a lower cost than usual for these services. When covered, specialty care services are performed by plan specialists and a different fee will apply. To see a complete fee schedule, including exclusions and limitations, visit DominionNational.com/kaiserdentists​ or call Dominion Member Services at 1-855-733-7524 (TTY 711), Monday through Friday, 7:30 a.m. to 6 p.m. When you become a member, you will find the fee schedule in your Evidence of Coverage.

BrainHQ—Brain training that works

Your brain defines who you are.

​ It’s the center of everything you think, do, and feel. That’s why Kaiser Permanente is offering BrainHQ: online exercises you can do on a computer or mobile device that improve cognitive function (including memory, attention, and processing speed) as well as daily life (including safer driving, improved balance, and better mood)—and people who use it notice the difference.

What's more, BrainHQ supports you every step of the way, with great features such as:
  • Weekly challenges to inspire you to improve
  • A personalized trainer that tailors your training to your needs
  • Progress reports that provide insight into how you're doing
  • Flexible training that fits your schedule
  • A monthly newsletter with brain health news, tips, and recipes

If you have questions, please contact the BrainHQ help line via email at support@brainhq.com or call 1-877-573-3067, Monday through Friday, 7:30 a.m, to 4:30 p.m., Pacific Time.

Wellness programs

Our Health Education Departments offer health classes and support groups at our facilities, some of which may require a fee. Course catalogs are available at our Health Education Departments. Registration is required.

To register, call 1-800-444-6696​ anytime, day or night.

You can also browse course listings online at kp.org/classes.

Online wellness programs

Our online healthy lifestyle programs create customized action plans tailored to your health needs and areas of interest. Start with a Total Health Assessment and go from there.

Visit kp.org/healthylifestyles.

Care away from home (New for 2020)

With Kaiser Permanente Medicare Advantage, you're covered worldwide for urgent and emergency care. Just go to the nearest urgent care or emergency facility wherever you're traveling.

For added convenience, our members can receive in-person urgent care services at CVS MinuteClinic® locations2while traveling outside of states where Kaiser Permanente operates. Be sure to bring your Kaiser Permanente ID card and appropriate method of payment.

Click or tap to see disclosures and footnotes

1 Not available with Kaiser Permanente Medicare Advantage Value Baltimore (HMO), Kaiser Permanente Medicare Advantage Value MD (HMO), and Kaiser Permanente Medicare Advantage Liberty (HMO) plans. Members are responsible for any charged amounts for covered services that exceed the annual allowance maximum of $1,200. Coverage limited to inside the United States and its territories. See your Evidence of Coverage for details.

2 Hearing aid allowance can only be used for hearing aids purchased at Kaiser Permanente audiology centers.

3 Based on June 2020 pricing. Pricing is subject to change.

4 Please refer to your Evidence of Coverage for details. OTC benefits may change each year on January 1. Each order must be at least $20. Any unused portion of the quarterly benefit limit will not carry forward to the next quarter. Your order may not exceed your quarterly benefit limit. Limitations and restrictions may apply. Cash, check, credits cards, or money orders are not accepted.

5Silver&Fit is not available with Kaiser Permanente Medicare Advantage (HMO) Value Balt, Kaiser Permanente Medicare Advantage (HMO) Value MD, or Kaiser Permanente Medicare Advantage (HMO) Value DC plans. The Silver&Fit program is provided by American Specialty Health Fitness, Inc. (ASH Fitness), a subsidiary of American Specialty Health Incorporated (ASH). Silver&Fit is a registered trademark of ASH and used with permission herein. All programs and services are not available in all areas. Participating fitness centers and fitness chains may vary by location and are subject to change.

6Kits are subject to change and once selected cannot be exchanged.

7Purchase of a wearable fitness device or app may be required and is not reimbursed by the Silver&Fit program. Rewards are subject to change. The products and services described above are neither offered nor guaranteed under our contract with the Medicare program. In addition, they are not subject to the Medicare appeals process. Any disputes regarding these products and services may be subject to the Kaiser Permanente Medicare Advantage (HMO) grievance process.

8Twenty-four one-way rides per contract year. For nonemergency transportation only.

Ready to get started?

Call us at 1-877-218-9489​ (TTY 711) or schedule a Personal Appointment, and we’ll walk you through your options. Our friendly representatives are available, 7 days a week, 8 a.m. to 8 p.m. Hablamos español.

Enroll now

Connect with a Kaiser Permanente Medicare specialist​ in your area.

Call to enroll

Call 1-877-218-9489​ (TTY 711) to speak with a Kaiser Permanente Medicare Specialist.

Attend a seminar

Find a seminar​ in your area to learn more about our Kaiser Permanente Medicare health plans.

Concerned about affording coverage? We may be able to help.

Ready to enroll?

Set up a personal appointment

Connect with a licensed Kaiser Permanente Medicare Specialist in your area, on your schedule. Simply complete the form (click or tap to open)​ and we'll contact you to set up an appointment.

Connect now

Attend a seminar

Find a seminar​ in your area to learn more about our Kaiser Permanente Medicare health plans.

Call to enroll

Call 1-877-218-9489​ (TTY 711) to speak with a Kaiser Permanente Medicare Specialist 7 days a week, 8AM-8PM. They will walk you through your options and get you signed up right over the phone.

Enroll online

Enrolling in our Medicare Advantage Plans online is simple. Click or tap to be taken to our enrollment site,​ answer a few questions, and you're done.

Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. ​ 2101 E. Jefferson St., Rockville, MD 20852

Kaiser Permanente is an HMO plan with a Medicare contract. Enrollment in Kaiser Permanente depends on contract renewal. You must reside in the Kaiser Permanente Medicare health plan service area in which you enroll.

For accommodations of persons with special needs at meetings, call 1-877-218-9489 (TTY 711).

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© 2021-2022 Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.

Page last updated on October 26, 2021