Enrollment materials

Click on the links below for detailed information about Kaiser Permanente’s Medicare health plans.

Medicare plan rating sheet.† Also available in Spanish† (en español)
Pre-Enrollment Checklist† Also available in Spanish†​ (en español)
One Pass Flyer†

Advantage Plus Brochure†

Summary of Benefits (SB)

Summary of Benefits for Medicare Advantage High, Standard, and Value Balt and MD (HMO and HMO-POS).† Also available in Spanish† (en español) Summary of Benefits for Medicare Advantage Care Plus MD (HMO-POS).† Also available in Spanish†​ (en español)

Summary of Benefits for Medicare Advantage High, Standard, and Value VA (HMO-POS).†
Also available in Spanish† (en español)

Summary of Benefits for Medicare Advantage Care Plus VA (HMO-POS).
Also available in Spanish†​ (en español)

Summary of Benefits for Medicare Advantage High, Standard, and Value DC (HMO-POS).†
Also available in Spanish†​ (en español) ​ ​

Summary of Benefits for Medicare Advantage Liberty without Part D (HMO)†
Also available in Spanish†​ (en español) ​

Note: If you have health care coverage through an employer or trust fund, please contact your benefits administrator for information about your group plan. ​

Evidence of Coverage (EOC)

EOC for Kaiser Permanente Medicare Advantage High, Standard, and Value plans (HMO and HMO-POS) †
Also available in Spanish† (en español)

EOC for Kaiser Permanente Medicare Advantage Care Plus MD plan (HMO-POS)†

EOC for Kaiser Permanente Medicare Advantage Liberty Without Part D (HMO)†

EOC for Kaiser Permanente Medicare Advantage Care Plus VA plan (HMO-POS)†
Also available in Spanish† (en español)

Annual Notice of Changes (ANOC)

Maryland
(Anne Arundel, Calvert, Carroll, Charles, Frederick, Harford, Howard, Montgomery, and Prince George’s counties)
ANOC for Kaiser Permanente Medicare Advantage High MD (HMO-POS)† ANOC for Kaiser Permanente Medicare Advantage Standard MD (HMO-POS)† ANOC for Kaiser Permanente Medicare Advantage Value MD (HMO)† Also available in Spanish† (en español)
Baltimore City/Baltimore County
ANOC for Kaiser Permanente Medicare Advantage High MD (HMO-POS)† ANOC for Kaiser Permanente Medicare Advantage Standard MD (HMO-POS)† ANOC for Kaiser Permanente Medicare Advantage Value Baltimore (HMO)†
Virginia
ANOC for Kaiser Permanente Medicare Advantage High VA (HMO-POS)† Also available in Spanish† (en español) ANOC for Kaiser Permanente Medicare Advantage Standard VA (HMO-POS)† Also available in Spanish† (en español) ANOC for Kaiser Permanente Medicare Advantage Value VA (HMO-POS)† Also available in Spanish† (en español) ANOC for Kaiser Permanente Medicare Advantage Care Plus VA (HMO-POS)† Also available in Spanish† (en español)
Washington, DC
ANOC for Kaiser Permanente Medicare Advantage High DC (HMO-POS)† ANOC for Kaiser Permanente Medicare Advantage Standard DC (HMO-POS)† ANOC for Kaiser Permanente Medicare Advantage Value DC (HMO-POS)†
Maryland, Virginia, and Washington, DC
ANOC for Kaiser Permanente Medicare Advantage Liberty without Part D (HMO)†

Enrollment form

Kaiser Permanente Medicare Advantage enrollment form English†—also in Spanish† (en español)

Advantage Plus enrollment form†

Notices

Nondiscrimination notice† Also available in Spanish† (en español)

Multi-language interpreter service†

Formularies and directories

Medicare Part D comprehensive formulary†

Also available in Spanish (en español)†

Provider directory English† Provider directory updates†

Provider directory Spanish Provider directory updates†

Pharmacy directory English†

Pharmacy directory Spanish†

†You will need the free Adobe Acrobat Reader to read this file. Kaiser Permanente is not responsible for the content or policies of external Internet sites. Details.

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

Learn more about financial assistance

Ready to learn more?

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.

Attend a seminar

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

Call to learn more

Call 1-855-357-5101, (TTY 711) to speak with a Kaiser Permanente Medicare specialist 7 days a week, 8 a.m. – 8 p.m. They will walk you through your options over the phone.
Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. ​ 2101 East Jefferson Street, Rockville, MD 20850
Language assistance |  Nondiscrimination notice |  Privacy policy |  Accessibility |  Disaster Planning |  Terms and conditions

Kaiser Permanente is an HMO  and HMO-POS 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 1-866-975-7803 (TTY 711)  7 days a week, 8 a.m. to 8 p.m. 

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© 2024-2025 Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.

Page last updated on December 8, 2024 at 12 a.m. EST

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Click here to find a local Kaiser Permanente Medicare specialist or call 1-855-357-5101, TTY (711) 7 days a week, 8 a.m. to 8 p.m.

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