Medicare Advantage · HMOPOS
Kaiser Permanente
Plan year 2026

Kaiser Permanente Senior Advantage Care Plus (HMO-POS) H1170-013

4.5 · 2026 Star Rating · source: CMS · Ratings are updated annually
Monthly premium
$0
+ your Part B premium
Max out-of-pocket
$8,000
in-network annual cap
Primary care
$10
per visit copay
Specialist
$40
per visit

Your costs at a glanceIn-network, for the 2026 plan year

Rx deductible
$0
Inpatient hospital
Days 1-6: $395/day, Days 7-90: $0/day, then $0/day
no limit on covered hospital days
Inpatient mental health
Days 1-5: $395/day, Days 6-90: $0/day
Outpatient surgery
$275
Emergency room
$115
Urgent care
$40

What's included, and what it's actually worth5 benefits included. Tap any card for the detail

Vision

$500eyewear allowance per 2 years
Eyewear allowance$500 eyewear allowance per 2 years
This is a supplemental benefit with plan-specific limits. See plan documents for details.

OTC allowance

$25/quarter OTC allowance
Prepaid card$25/quarter OTC allowance
See more details about this plan
Doctor Visits: PCP$10 copay
In-network$10 copay per visit
Doctor Visits: Specialist$40 copay
In-network$40 copay per visit
Inpatient Hospital$395/day, days 1–6
In-networkDays 1-6: $395/day, Days 7-90: $0/day, then $0/day
Benefit limitNone — additional covered days are unlimited
Outpatient Surgery$275 copay
In-network$275 copay per procedure
Mental HealthDays 1-5: $395/day, Days 6-90: $0/day
Inpatient psychiatricDays 1-5: $395/day, Days 6-90: $0/day
Fitness$0 fitness benefit
Transportation18 one-way trips/year ($125 copay per trip)
Trips per year18 one-way trips/year ($125 copay per trip)
MealsMeal benefit

Your coverageCheck your coverageFrom the doctors and prescriptions you added

Your plan's drug tiers30-day retail · after any applicable deductible

Tier 1
$0
Preferred Generic
Tier 2
$0
Generic
Tier 3
$47
Preferred Brand
Tier 4
$95
Non-Pref Brand
Tier 5
33%
Specialty
Tier 6
$0
Tier 6

Our take

Where this plan shines

This plan has a $0 monthly premium.
No separate drug deductible.
Highly rated by CMS (4.5 stars).

Things to know before you enroll

This plan’s out-of-pocket maximum is above the national median.
Limited coverage while traveling outside the plan’s service area.
Questions? Talk to a licensed agent at1-866-764-3312 (TTY: 711)

Plan documents

Plan questions

Common questions about Kaiser Permanente Senior Advantage Care Plus (HMO-POS) (HMOPOS)

What does Kaiser Permanente Senior Advantage Care Plus (HMO-POS) (HMOPOS) cover?

Kaiser Permanente Senior Advantage Care Plus (HMO-POS) (HMOPOS) is a Medicare Advantage plan that the current plan record identifies as including Part D prescription drug coverage. The plan record also identifies Part D prescription drug coverage. Its published drug benefit lists 6 formulary tiers. Published supplemental benefits include vision ($500 eyewear allowance per 2 years), over-the-counter (OTC) ($25/quarter OTC allowance), fitness ($0 fitness benefit), and transportation (18 one-way trips/year ($125 copay per trip)). Review the plan documents for covered services, limits, and rules. Coverage can change each plan year.

Learn about Medicare Advantage

How much does Kaiser Permanente Senior Advantage Care Plus (HMO-POS) (HMOPOS) cost in 2026?

The published 2026 monthly plan premium for Kaiser Permanente Senior Advantage Care Plus (HMO-POS) (HMOPOS) is $0. The standard Part B premium is $202.90/month in 2026 for most people; assistance may pay it for some members. The listed Part D deductible is $0. The in-network medical out-of-pocket maximum is $8,000; it does not include Part D drug spending. Published visit costs include primary care $10 and specialist visits $40. These figures are plan data, not a personal yearly-cost estimate.

Understand Medicare drug-cost limits

Can I use my current doctors with Kaiser Permanente Senior Advantage Care Plus (HMO-POS) (HMOPOS)?

CMS lists Kaiser Permanente Senior Advantage Care Plus (HMO-POS) (HMOPOS) as a HMOPOS plan. The record also identifies point-of-service flexibility, but exact out-of-network rules can vary. A network label alone does not confirm that a specific doctor participates. Use the doctor lookup tool, then confirm with the doctor's office and the plan before receiving care. Provider networks and member costs can change. Emergency care and travel coverage can follow different network rules.

Check your doctors

Does Kaiser Permanente Senior Advantage Care Plus (HMO-POS) (HMOPOS) cover my prescriptions?

Kaiser Permanente Senior Advantage Care Plus (HMO-POS) (HMOPOS) has 6 published formulary tiers in the current plan record. Published preferred-pharmacy 30-day retail costs include Tier 1 at $0, Tier 2 at $0, Tier 3 at $47, Tier 4 at $95, and Tier 5 at 33%. The listed Part D deductible is $0. A tier listing does not confirm that a specific prescription is covered. Check each medication against the plan's current formulary, restrictions, pharmacy network, and costs before enrolling.

Check your prescriptions

What dental, vision, and hearing benefits does Kaiser Permanente Senior Advantage Care Plus (HMO-POS) (HMOPOS) include?

The current plan record for Kaiser Permanente Senior Advantage Care Plus (HMO-POS) (HMOPOS) lists vision ($500 eyewear allowance per 2 years). It also lists over-the-counter (OTC) ($25/quarter OTC allowance). The current data does not list dental and hearing as offered benefits. Benefit allowances, frequency, eligibility, and participating providers can have additional limits, so review the Summary of Benefits or Evidence of Coverage for the complete rules.

When can I enroll in Kaiser Permanente Senior Advantage Care Plus (HMO-POS) (HMOPOS)?

Kaiser Permanente Senior Advantage Care Plus (HMO-POS) (HMOPOS) is a 2026 Medicare Advantage plan. The Annual Enrollment Period runs from October 15 through December 7, with changes taking effect January 1. The Medicare Advantage Open Enrollment Period runs from January 1 through March 31 for people already enrolled in Medicare Advantage. A qualifying circumstance may create a Special Enrollment Period outside those dates. Confirm the enrollment window and effective date that apply to you before changing coverage.

Review Medicare enrollment periods

More plan options

Browse the full 2026 Medicare Advantage with drug coverage directory. This plan is offered in Georgia. Plan availability can vary by county.

Helpful next steps

Kaiser Permanente Senior Advantage Care Plus H1170-013 (HMO-POS) — 2026