Can Medicare patients use Kaiser?
Asked by: Johnathan Rempel Sr. | Last update: May 27, 2025Score: 4.3/5 (59 votes)
Can I use Kaiser if I have Medicare?
People who have both Medicare and Medicaid/Medi-Cal coverage may be eligible for extra benefits through a Kaiser Permanente Dual Complete or Dual Essential (HMO D-SNP) Plan. A Dual Plan lets you keep your Medicaid/Medi-Cal benefits and includes more benefits than Original Medicare.
Can you go to any doctor if you have Medicare?
With Original Medicare, you can:
Go to any doctor or hospital that takes Medicare, anywhere in the U.S. Find providers that work with Medicare. Join a separate Medicare drug plan (Part D) to get drug coverage. Buy a Medicare Supplement Insurance (Medigap) policy to help lower your share of costs for services you get.
Can someone with Medi-Cal go to Kaiser?
Individuals who qualify for Medi-Cal will have no or low monthly premiums, no copays, and no out-of-pocket costs for most covered services. At Kaiser Permanente, you have a wide network of doctors and specialists to choose from. All of our doctors accept Kaiser Permanente Medi-Cal members.
Is Kaiser a good Medicare plan?
— Kaiser Permanente's Medicare Advantage health plans are highly rated, according to the Centers for Medicare & Medicaid Services 2025 Star Ratings. All Kaiser Permanente Medicare Advantage plans earned either 4 or 4.5 stars out of a maximum of 5 stars.
KAISER AND OFW
What is a disadvantage of choosing Kaiser?
Limited plan types: Kaiser offers mostly HMO plans, so most members must work within Kaiser's network of medical providers. Low member experience ratings: Kaiser's member experience ratings, including customer service and getting needed care, are lower than most major providers.
How to switch Medi-Cal to kaiser?
To learn how to enroll in Kaiser Permanente, call Medi-Cal HCO Monday – Friday, 8 a.m. to 6 p.m. at (800) 430-4263 (TTY: (800) 430-7077).
Can I go to Kaiser without insurance in California?
The Medical Financial Assistance program helps low-income, uninsured, or underinsured patients who need help paying for all or part of their medical care received from Kaiser Permanente. Patients are eligible for financial assistance when their family income is at or below 400% of the Federal Poverty Guidelines (FPG).
What does Medi-Cal not cover?
Restricted scope Medi-Cal covers limited services. It does not cover medicine or primary care. If you have pregnancy-related limited scope Medi-Cal, you will have the full scope of Medi-Cal benefits, if the service is medically necessary.
Does everyone have to pay $170 a month for Medicare?
Most people pay no premiums for Part A. For Medicare Part B in 2025, most beneficiaries will pay $185 per month. Certain factors may require you to pay more or less than the standard Medicare Part B premium in 2025.
What are the 6 things Medicare doesn't cover?
- Eye exams (for prescription eyeglasses)
- Long-term care.
- Cosmetic surgery.
- Massage therapy.
- Routine physical exams.
- Hearing aids and exams for fitting them.
Why are doctors not taking Medicare patients?
In recent years, physician groups and some policymakers have raised concerns that physicians would opt out of Medicare due to reductions in Medicare payments for many Part B services, potentially leading to a shortage of physicians willing to treat people with Medicare.
Can non-Kaiser members go to Kaiser?
If you're not a member:
No problem. We accept a variety of non–Kaiser Permanente health coverage. You'll typically pay a copay, coinsurance, or deductible payment, depending on your plan. Learn more about coverage that's accepted.
Can you see any doctor with Medicare?
In many cases, you can only use doctors and other providers who are in the plan's network and service area (for non-emergency care). A written order from your primary care doctor for you to visit a specialist or get certain medical services. Without a referral, your plan may not pay for services from a specialist.
Who qualifies for Kaiser OTC benefits?
If you have questions or to learn more about the OTC health and wellness benefit, call the Member Service Contact Center at 1-800-443-0815 (TTY 711), 7 days a week, 8 a.m. to 8 p.m. Who can use this benefit? You must be a Kaiser Permanente Medicare health plan member covered under your employer group.
Does Kaiser accept Medicare in California?
For accommodations of persons with special needs at meetings call 1-877-485-3566 (toll free) or call TTY 711. In California, Hawaii, and Washington, Kaiser Permanente is an HMO plan with a Medicare contract.
Can Kaiser bill me my copay?
Copayments, deductibles and other patient cost shares
If you are not able to pay these amounts at the time you receive care or services, you will receive a bill.
What do I do if I don't have health insurance in California?
Get coverage
If you do not have coverage, open enrollment continues through January 31, 2024. Visit Apply | Covered California™ or call 800-300-1506 to sign up for health care coverage.
Can I keep Kaiser if I get Medi-Cal?
Yes, if the county decides that you or your family no longer qualify for Medi-Cal, your file will be sent to Covered California to be reviewed for financial help through Covered California. If so, you may be able to stay with Kaiser Permanente.
Can you have Medi-Cal and another insurance at the same time?
(For Adults Age 19 and above, updated: June 2016) Myth 1: One can not have Medi-Cal and any other insurance at the same time. Fact: There are no restrictions on multiple coverage under Medi-Cal regulations.
Which Medi-Cal plan is best?
OAKLAND, Calif., Jan. 19, 2023 – Kaiser Permanente Northern California's Medi-Cal health plan is the highest rated in the state for quality care, according to a December 2022 report from the state's Department of Health Care Services (DHCS).
Is Kaiser a good choice for Medicare?
Kaiser Permanente's Medicare Advantage health plans are highly rated, according to the Centers for Medicare & Medicaid Services (CMS) 2025 Star ratings. Every year, Medicare evaluates plans based on a 5-star rating system.
Why do doctors leave Kaiser?
The biggest gripe I've heard as a chief and experienced as a Kaiser physician is the lack of flexibility or the lack of autonomy. Clinic, OR, and call schedules are made 6-months in advance. The clinic template is also preset. If you want to start clinic a little bit later, that's not possible.
Do doctors prefer HMO or PPO?
HMO plans might involve more bureaucracy and can limit doctors' ability to practice medicine as they see fit due to stricter guidelines on treatment protocols. So just as with patients, providers who prefer a greater degree of flexibility tend to prefer PPO plans.