What Is the Kaiser Senior Advantage Plan?

What Is the Kaiser Senior Advantage Plan?

The Kaiser Senior Advantage Plan is a Health Maintenance Organization plan offered by Kaiser Permanente. The plan works through a network of providers and is suitable for retirees age 50 and older. It covers inpatient and outpatient care, dental, hearing and vision services, home health care, and certain drugs.

To benefit from the Kaiser Senior Advantage Plan, individuals must select a primary care physician from Kaiser's network. This physician authorizes care, makes referrals to specialists and coordinates the member's medical care.

Kaiser Senior Advantage Plan covers out-of-network services only in emergencies. It is suitable for an individual who prefers having a single physician manage his medical care or who desires lower out-of-the-pocket expenditures. Under this plan, Kaiser handles Medicare benefits.

The plan covers inpatient hospital care for an unlimited number of days with co-payment for the first six days, as of 2015. Outpatient care includes doctor visits, diagnostic tests, diabetes services and supplies, emergency and ambulance services, and outpatient surgery. The plan also offers chiropractic care, behavioral health services, preventive care, hospice services and outpatient substance abuse care.

The plan also covers certain generic and non-generic drugs and vaccines. However, it does not cover over-the-counter medical supplies and alternative treatments.