This is a Medicare Advantage plan, which means that it generally replaces your Medicare coverage. You agree to let Kaiser manage your Medicare benefits. It is an HMO (health maintenance organization) with a closed network of providers. Show
Kaiser Permanente Senior Advantage is considered the “partner plan” of Kaiser HMO. That means that if you are a retiree enrolled in Kaiser HMO, you’ll be transferred into Kaiser Permanente Senior Advantage when you turn 65, once Medicare has approved your enrollment form.
New for 2023Cost sharing will be eliminated for lactation supplies and services, as well as male condoms. How the plan works
Best fit for you if:
Learn moreIf you will be Medicare-eligible in 2023 and would like to learn more about Kaiser Senior Advantage, register for a virtual information session. 2023 plan costsTypical out-of-pocket costs
Moving outside California?UC offers a Medicare Coordinator Program (administered by Via Benefits) to retirees and to families whose members are all eligible for or enrolled in Medicare and live in a state outside California. If you’re planning to be away from home for something like school, vacation, or a business trip, there are plenty of ways to prepare yourself for a healthy experience. Find answers to common care, cost, and coverage questions here. Note: If you’re planning a more permanent relocation, like moving, contact Member Services to discuss your coverage options. In-person Kaiser Permanente care is available in many areas across the United States, including all or parts of:
You can get care in these areas and find Kaiser Permanente locations at kp.org/kpfacilities. If you’re traveling to another Kaiser Permanente area, you can get most of the same routine and specialty care you’d receive near home.1 For specialty care, make sure you’ve been referred by a Kaiser Permanente clinician or affiliated provider in the area you’re visiting. Across the U.S., you can also get 24/7 care from a Kaiser Permanente clinician by phone or online. Sign in to your kp.org account to find the right care method for you and get started. And remember: As a Kaiser Permanente member, you’re covered for emergency and urgent care anywhere in the world.2 Find out more about your care options on the “How to get care while you’re traveling” page. To learn more about the services covered under your specific plan, check your Evidence of Coverage or call the Away from Home Travel Line at 951-268-3900 (TTY 711).3 There are plenty of ways to plan for a healthy trip. Here are some ways to make sure you’re prepared to get care if you need it: What to do before traveling
What to research before traveling
What to pack for your trip
What you pay for care depends on your plan, but how and when you pay for care may depend on where you’re traveling. Here’s what to expect when you get care away from home, so you can avoid financial surprises later. In a Kaiser Permanente area: If your plan lets you get care when you visit another Kaiser Permanente area, you’ll pay what you normally would — for example, a copay, coinsurance, or deductible payment. If what you pay doesn’t cover all of what you owe for the care you received, you’ll get a bill for the difference later. For more specific information on your coverage, please check your plan details. If you’re a WEX financial account holder, you may have a different point-of-service payment experience than you do at home. Any costs incurred while you’re traveling will need to be manually submitted to your financial account for reimbursement. Outside of a Kaiser Permanente area: For emergency or urgent care in the U.S., the facility may bill Kaiser Permanente directly.2 But you’ll still need to pay any copays, coinsurance, or deductibles that apply under your plan.5 In some cases, you may be asked to pay upfront for services you receive. In this case, you’ll need to file a claim for reimbursement. Outside the U.S.: In many countries, providers require payment before giving care. Costs can be high, so be ready to cover any unexpected costs. You may want to get extra travel insurance for your trip. To request reimbursement through your health plan, you’ll need to submit any bills or invoices to Kaiser Permanente for review and processing. If you need help coordinating your care or payment while traveling internationally, call the Away from Home Travel Line at 951-268-3900(TTY 711).3 It’s important to remember that how you get care can vary depending on where you are. So, plan ahead and find out what emergency and other medical services are available where you’ll be traveling. Reimbursement: You can request a reimbursement for emergency or urgent care when you pay for it out of pocket.2,5,6 Just be sure to submit a claim for reimbursement once you get back home. For details on filing a claim, visit the “How to get reimbursed for care after you travel” page. Going away to college can be challenging. But a little planning can make a big difference. Here are a few easy ways to prepare for college:
If you ever have questions about your Kaiser Permanente health coverage, care, and claims while you’re away, call the Away from Home Travel Line at 951-268-3900 (TTY 711).3 If you’re in a different Kaiser Permanente area for college and want to receive care in person or online, you’ll need to create a new medical record number for the area you’re in.8,9
After you get your new medical record number, you’ll be able to schedule appointments right away, plus track and manage the Kaiser Permanente care you get while traveling.10 You don’t need a new medical record number to access urgent or emergency care.2 Learn more about the types of Kaiser Permanente care you can get while you’re away. You’re covered for urgent and emergency care anywhere in the world.2 For routine care (such as checkups, preventive screenings, and flu shots), consider signing up for a student health plan through your college. Keeping up with routine care means you can:
Routine care also includes:
Keep your Kaiser Permanente coverage so you can:
Across the U.S., you can also get 24/7 care from a Kaiser Permanente clinician by phone or online — always tracked in your electronic health record. Sign in to your kp.org account to find the right care method for you and get started. Managing your care while you travel11If you’re traveling and want to receive care in a different Kaiser Permanente area, you’ll need to create a new medical record number for the area you’re visiting.8,9
After you get your new medical record number, you’ll be able to schedule appointments right away, access 24/7 care by phone or online, and track and manage the Kaiser Permanente care you get while traveling.10 You don’t need a new medical record number to access urgent or emergency care.2 Yes. Across the U.S., most members can get 24/7 care from a Kaiser Permanente clinician by phone or online — always tracked in your electronic health record. Sign in to your kp.org account to find the right care method for you and see what is available in your area. As a member, you can get most of the same services you would get in your home area when visiting another Kaiser Permanente area, including:1,12,13,14 Inpatient services
Outpatient services
X-ray and lab services
Prescription drugs
Mental health/chemical dependency services
Skilled nursing facility services
Certain types of care require approval by Kaiser Permanente. If these services are included in your plan and available in the area you’re visiting, they’re available to you but require approval from your home area:
To learn more about the services covered under your specific plan, check your Evidence of Coverage, Certificate of Insurance, or Summary Plan Description, or call the Away from Home Travel Line at 951-268-3900(TTY 711).3 The following services, equipment, and supplies aren’t available to you in other Kaiser Permanente areas:
For more information about getting care in another Kaiser Permanente area:
You’ll find more detailed, up-to-date information about getting care in the following document(s) that apply to your health coverage:
Contact Member Services to request a copy of your EOC or COI. To request a copy of your SPD, contact your employer. You’re covered for emergency and urgent care anywhere in the world.2 To learn more about getting care outside of a Kaiser Permanente area, visit the “How to get care while you’re traveling” page. Most Kaiser Permanente plans don’t cover routine care (like checkups, preventive screenings, and flu shots) outside of a Kaiser Permanente area, so make sure to get them before your trip.14 If you’ll be away for a long period of time, call the Away from Home Travel Line at 951-268-3900 (TTY 711) to learn about your coverage options.3 Some plans may direct you to purchase supplemental coverage for routine care, like a student health plan. Learn more about preparing for college. Reviewed: September 2022 1These services are covered as long as they’re provided or referred by a Kaiser Permanente provider or affiliated provider in the area you’re visiting. These services are subject to the terms and conditions, including prior authorization, approval, and copay, coinsurance, or deductible requirements, of your plan coverage issued in your home area. 2If you believe you have an emergency medical condition, call 911 or go to the nearest hospital. For the complete definition of an emergency medical condition, please refer to your Evidence of Coverage or other coverage documents. 3This number can be dialed inside and outside the United States. Before the phone number, dial “001” for landlines and “+1” for mobile lines if you’re outside the country. Long-distance charges may apply, and we can’t accept collect calls. The phone line is closed on major holidays (New Year’s Day, Easter, Memorial Day, July Fourth, Labor Day, Thanksgiving, and Christmas). It closes early the day before a holiday at 10 p.m. Pacific time (PT), and it reopens the day after a holiday at 4 a.m. PT. 4These features are available when you register on kp.org and seek care from Kaiser Permanente providers. 5Medicare members should check their Evidence of Coverage (EOC) for more details. In the Mid-Atlantic States Region, all Direct Pay Kaiser Permanente Medicare Plus High Option and Standard Option plan members have worldwide emergency care and urgent care coverage, and all Direct Pay Kaiser Permanente Medicare Plus Basic Option plan members have emergency care and urgent care coverage while inside the United States and its territories only. 6The amount members are reimbursed will depend on what their copays or coinsurance are, whether they have a deductible, and other plan limitations, consistent with the terms of the member’s Evidence of Coverage or other coverage documents. 7Kaiser Permanente prescription delivery is not available in Arkansas, Kansas, Louisiana, North Carolina, North Dakota, New Hampshire, Nebraska, Oklahoma, South Carolina, or South Dakota. 8Washington can’t be added as a visiting area of care on kp.org at this time. Non–Washington members looking to get care in Washington outside of the Vancouver/Longview area should call the Away from Home Travel Line at 951-268-3900 (TTY 711) for help. 9You can add an area of care to your own account only. You won’t be able to add an area of care for someone else if you’re acting as their caregiver. 10When appropriate and available. If you travel out of state, phone appointments and video visits may not be available in select states due to licensing laws.Laws differ by state. 11When you get care in other Kaiser Permanente service areas, your home-area claims and appeals, or grievance processes, still apply. Members can file a grievance with or without a denial letter. See your Evidence of Coverage, Certificate of Insurance, or Summary Plan Description for details. 12When visiting smaller Kaiser Permanente areas of care, you can still receive in-person medical treatment, but it will likely be through an affiliated provider. Call the Away from Home Travel Line at 951-268-3900 (TTY 711) for more details. 13Visiting member benefits are not available to HSA, Medicaid, and QUEST plan members. Contact Member Services in your home area for details. 14This does not include a complete list of exclusions or available services. Services may vary by service area. Please refer to your Evidence of Coverage, Certificate of Insurance, Summary Plan Description, or Membership Agreement for details of your specific coverage. For more specific information about visiting member services, call the Away from Home Travel Line at 951-268-3900 (TTY 711). 15For members in Maryland, coverage for physical, occupational, and speech therapy is different. Call Member Services to learn more. 16Certain limitations apply to home health care. Can Kaiser be used internationally?As a Kaiser Permanente member, you're covered for emergency and urgent care anywhere in the world. Whether you're traveling in the United States or a foreign country, this brochure will explain what to do if you need emergency or urgent care during your trip.
Does Medi cal cover you internationally?The U.S. government does not provide medical insurance for U.S. citizens overseas. We do not pay medical bills. You should purchase insurance before you travel.
Does Covered California cover out of country?If students are tax dependents, they can be covered under their parents' Covered California health plan, no matter where they live. However, Covered California does not offer any health plan products that have a network of doctors, hospitals or other health care providers outside of California at this time.
Is Kaiser International the same as Kaiser Permanente?Kaiser Permanente International is an educational subsidiary that introduces health care leaders who are based outside the United States to the Kaiser Permanente model.
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