Kaiser Permanente Senior Advantage Gold (HMO-POS)

KAISER FOUNDATION HP OF CO · 2026 plan year

Plan ID H0630-016-000

HMOPOS★ 4.5 CMS Stars
MOOP (in-network)
$2,900
MOOP (combined)
—
Monthly premium
$189/mo
Part C $177.50 + Part D $11.50, before Extra Help
Prescription drugs
Included

This plan in 2027

Plan information

Contract / Plan / Segment
H0630-016-000
Medical deductible
$0 — no deductible
Part D premium
$11.50/mo (part of the monthly premium above)Before Extra Help, which can lower or remove it for people with limited income.
Part D deductible
$0/yr
Also owed
Your Medicare Part B premium, paid separately

More KAISER FOUNDATION HP OF CO plans in CO

Benefits & cost sharing

Hospital

BenefitIn-network
Inpatient Hospital — Additional Days (Acute)No charge
Inpatient Hospital — Acute$215/day for days 1–6, $0 after
Inpatient Hospital — Psychiatric$215/day for days 1–6, $0 after
Worldwide Urgent Care Coverage$35

Pharmacy

BenefitIn-network
Part B DrugsSee plan details
Chemotherapy & Radiation Drugs (Part B)$0-$47 copay + 0%-20% coinsurance
Other Part B Drugs$0-$47 copay + 0%-20% coinsurance

Mental Health

BenefitIn-network
Mental Health — Individual Sessions$5
Mental Health — Group SessionsNo charge
Mental Health Specialty ServicesSee plan details
Supplemental Health BenefitsSee plan details

Other

BenefitIn-network
Vision — Eyeglasses (Lenses & Frames)No charge
Vision — Eyeglass LensesNo charge
Vision — Eyeglass FramesNo charge
Diagnostic Radiology$45-$230
Therapeutic Radiology$15
X-Ray ServicesNo charge
Outpatient Hospital Services$215
Diabetic SuppliesNo charge
Diabetic Therapeutic Shoes & Inserts20% coinsurance
Hearing — Fitting & Evaluation for Hearing AidNo charge
Cardiac & Pulmonary RehabilitationSee plan details
Medicare-Covered Preventive ServicesSee plan details
Medical Supplies20% coinsurance
Dental — Endodontics (Root Canal)50% coinsurance
Hearing — Routine ExamsNo charge
Diabetic Supplies & ServicesSee plan details
Skilled Nursing Facility (SNF)$0/day for days 1–10, $20/day for days 11–100
Cardiac Rehabilitation — Additional Sessions$0-$15
Intensive Cardiac Rehabilitation — Additional Sessions$0-$15
Pulmonary Rehabilitation — Additional Sessions$5
Supervised Exercise Therapy (SET)$25
Emergency Services$150
Urgently Needed Services$35
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency Coverage$150
Worldwide Emergency Transportation$250
Partial Hospitalization Program$45
Intensive Outpatient Program (IOP)$45
Home Health ServicesNo charge
Primary Care Physician ServicesNo charge
Chiropractic Services$15
Occupational Therapy Services$10
Physician Specialist Services$15
Podiatry Services$15
Podiatry ServicesNo charge
Other Health Care Professional Services$0-$15
Psychiatric ServicesSee plan details
Psychiatric Services — Individual Sessions$5
Psychiatric Services — Group SessionsNo charge
Physical Therapy & Speech-Language Pathology$10
Additional Telehealth Services (Part B)No charge
Opioid Treatment Program Services$15
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & TestsNo charge
Laboratory ServicesNo charge
Radiological ServicesSee plan details
Hospital Observation ServicesNo charge
Ambulatory Surgical Center (ASC)$125
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual Sessions$5
Substance Abuse — Group SessionsNo charge
Outpatient Blood ServicesNo charge
Ambulance ServicesSee plan details
Ground Ambulance$250
Air Ambulance$250
Non-Emergency Transportation — Health FacilityNo charge
Durable Medical Equipment (DME)0%-20% coinsurance
Prosthetics & OrthoticsSee plan details
Prosthetic Devices20% coinsurance
Dialysis Services20% coinsurance
Over-the-Counter (OTC) ItemsNo charge
Other Supplemental Benefit0%-20% coinsurance
Annual Physical ExamNo charge
Health EducationNo charge
Fitness BenefitNo charge
Remote Access TechnologiesNo charge
Kidney Disease Education Services$0-$15
Glaucoma ScreeningNo charge
Dental — Prophylaxis (Cleaning)No charge
Diabetes Self-Management TrainingNo charge
Digital Rectal ExamsNo charge
Welcome to Medicare EKGNo charge
Insulin (Part B)$0-$35
Dental — Medicare-Covered Services$15
Dental — PreventiveSee plan details
Dental — Oral ExamsNo charge
Dental — X-RaysNo charge
Dental — Diagnostic ServicesNo charge
Vision — Contact LensesNo charge
Dental — Fluoride TreatmentNo charge
Dental — ComprehensiveSee plan details
Dental — Restorative Services50% coinsurance
Dental — Periodontics (Gum Care)50% coinsurance
Dental — Removable Prosthodontics (Dentures)50% coinsurance
Dental — Maxillofacial Prosthetics50% coinsurance
Dental — Fixed Prosthodontics (Bridges)50% coinsurance
Dental — Oral & Maxillofacial Surgery50% coinsurance
Dental — Adjunctive General Services50% coinsurance
Vision — Eye ExamsNo charge
Vision — Eye ExamsSee plan details
Vision — Routine Eye ExamsNo charge
Vision — EyewearNo charge
Vision — EyewearSee plan details
Hearing — ExamsNo charge
Hearing — ExamsSee plan details
Hearing — Prescription Hearing AidsSee plan details
Hearing — Hearing Aids (All Types)No charge

Service area

  • CO: 11 counties

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