Solicite un kit de inscripción en un plan Liberty Call 1-866-975-7803 (TTY 711), los 7 días de la semana, de 8 a. m. a 8 p. m.
Responda para confirmar su presencia en un seminario en persona sobre el plan Liberty SIN COSTO1010
Para obtener más información, llame o haga clic.
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Monthly premium |
$0 |
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Annual deductible |
None |
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Doctor office visits |
$10 Primary $35 Specialist |
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Emergency care We cover emergency care anywhere in the world. |
$95 per emergency department visit |
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Urgently needed services We cover urgent care anywhere in the world. |
$35 per office visit |
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Preventive services1 |
No charge |
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Inpatient hospitalization |
$225 per day for days 1 through 5 No charge for the remainder of your stay |
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Outpatient surgery |
$200 |
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Skilled nursing facility Up to 100 days per benefit period |
$0 per day for days 1 through 20 $196 per day for days 21 through 100 |
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Lab, X-ray |
$0 Lab $10 X-ray |
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MRI, CT, and PET |
$100 |
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Physical therapy |
$35 per visit |
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Ambulance service Per one-way trip |
$250 |
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Fitness program Silver&Fit®9 |
No cost for membership to any of the participating facilities, exercise programs, digital fitness and well-being choices |
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Over-the-counter (OTC) wellness credit6 Quarterly allowance to purchase items such as cold remedies, antacids, pain relievers, etc. |
$30 quarterly allowance |
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Annual maximum out-of-pocket |
$6,900 |
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NEW: Comprehensive dental plan11
The comprehensive dental plan also include a $1,000 annual allowance with a 50% coinsurance for more extensive care, such as fillings, crowns, dentures, root canals, and more. |
$0 copay per visit |
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Hearing aids7 |
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ADVANTAGE PLUS(optional supplemental package) premium and benefits |
YOU PAY |
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Monthly premium in addition to monthly Medicare Advantage individual plan premium and monthly Medicare premium(s) |
$20 |
Comprehensive dental services6
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$500 annual allowance towards comprehensive dental services with a 50% coinsurance for a total of $1,500 when added together with the preventive dental benefit included in your Kaiser Permanente Medicare Advantage plan |
Hearing aids |
$1,000 allowance per ear every 3 years for a total of $2,000 per ear every 3 years when added together with the hearing aid benefit included in your Kaiser Permanente Medicare Advantage plan |
Eyeglasses and contact lenses |
$175 allowance per eyewear every 2 years which can be combined with the eyewear allowance included in your Kaiser Permanente Medicare Advantage plan. To see your vision allowance, please refer to your Evidence of Coverage. |
Puede inscribirse en Advantage Plus al mismo tiempo que se inscriba en Medicare Advantage o dentro de los 30 días posteriores.
Es un miembro nuevo si cumple alguna de las siguientes condiciones
Los miembros nuevos pueden agregar la cobertura de Advantage Plus dentro de los 30 días posteriores a la fecha de inicio de su inscripción. Generalmente, la cobertura empieza el primer día del mes siguiente a la fecha en que recibimos su formulario de inscripción de Advantage Plus† completo.
Si ya es miembro de un plan Medicare Advantage de Kaiser Permanente, puede agregar la cobertura de Advantage Plus en cualquier momento desde el 15 de octubre de 2022 hasta el 31 de marzo de 2023. Su cobertura de Advantage Plus comenzará en las siguientes fechas:
1 Every year, Medicare evaluates plans based on a 5-star rating system.
2 $0 copay for all preventive services covered under Original Medicare at zero cost sharing.
3 Permanente physicians are recognized as Top Doctors in Northern Virginia Magazine (2022), Washingtonian magazine (2021), and Baltimore magazine (2021).
4 If you travel out of state, phone appointments and video visits may not be available due to state laws that may prevent doctors and health care providers from providing care across state lines. Laws differ by state.
5 With 50% coinsurance.
6 Please refer to your Evidence of Coverage for details. OTC benefits may change each year on January 1. Each order must be at least $20. Any unused portion of the quarterly benefit limit will not carry forward to the next quarter. Your order may not exceed your quarterly benefit limit. Limitations and restrictions may apply. Cash, check, credits cards, or money orders are not accepted.
7 Hearing aid allowance can only be used for hearing aids purchased at Kaiser Permanente audiology centers.
8 Twenty-four one-way rides per contract year. For nonemergency transportation only.
9 Not available with Kaiser Permanente Medicare Advantage Value Balt, Kaiser Permanente Medicare Advantage Value MD, or Kaiser Permanente Medicare Advantage Value DC plans. The Silver&Fit program is provided by American Specialty Health Fitness, Inc. (ASH Fitness), a subsidiary of American Specialty Health Incorporated (ASH). Silver&Fit is a registered trademark of ASH and used with permission herein. All programs and services are not available in all areas. Participating fitness centers and fitness chains may vary by location and are subject to change.
10 Free with no obligation.
11 Dental benefits are underwritten by Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc., and administered by Dominion National. To find an in-network dentist, call 1-855-733-7524 or visit DominionNational.com/kaiserdentists.
For more information about benefits, please view the 2023 Summary of Benefits
© 2023-2024 Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.
Esta página se actualizó por última vez el 6 de octubre de 2023 a las 9 a. m., hora del este.
✖Cerrar
Después de hacer clic en “Continuar”, seleccione el botón “Inscribirme ahora” ubicado en “Inscribirme en línea en un plan individual” y, a continuación, elija el estado donde vive.
Después de hacer clic en “Continuar”, seleccione el botón “Inscribirme ahora” ubicado en “Inscribirme en línea en un plan individual” y, a continuación, elija el estado donde vive.
