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. 

Compare the costs and benefits of Kaiser Senior Advantage with other UC Medicare plans.

Plan changes for 2021

  • Prescription Drug Part D TrOOP (True Out-Of-Pocket) costs will increase from $6,350 to $6,550.
  • Copayments for certain services will increase slightly for low-income subsidy-eligible Medicare enrollees.
  • A meal benefit (2 meals a day for 4 weeks) has been added for patients discharged from the hospital with a primary diagnosis of congestive heart failure. This benefit is available once in a calendar year.
  • Outpatient prescription drugs with an over-the-counter equivalent will be excluded from coverage. This change will be applied in phases throughout 2021. This exclusion does not apply to insulin, preventive drugs (such as tobacco cessation), or to an entire class of drugs when one drug within the class becomes available over-the-counter.

How the plan works

  • You choose a primary care physician (PCP) from Kaiser’s network, who coordinates your care and refers you to specialists. Your costs will only be covered for services authorized by your primary care physician.
  • The plan provides coverage for services outside of the Kaiser network only in cases of emergency.
  • Kaiser provides behavioral health services.
  • The Centers for Medicare and Medicaid Services must approve the service area for each Medicare plan. If your home zip code is outside of the Kaiser Senior Advantage service area, you will not be eligible to enroll. Eligible zip codes can change throughout the year. Please contact the Retirement Administration Service Center, Kaiser or Medicare.gov if you have a question about the eligibility of a particular zip code.

Best fit for you if:

  • You want lower out-of-pocket costs
  • You like having one doctor manage your care
  • You are comfortable with out-of-network coverage only in emergencies

2021 plan costs

Typical out-of-pocket costs

  • Office visit/urgent care visit: $20 (preventive care has no charge)

  • Emergency room: $65

  • Hospital stay: $250

  • Prescription drugs: $5, generic; $25, brand name

ID cards

New members should receive ID cards from Kaiser. You may also order a copy of your ID card on the Kaiser website or call 800-464-4000 to request your ID number.

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.