Kaiser Permanente Medicare Advantage Vital Sound (HMO)

KAISER FOUNDATION HEALTH PLAN OF WASHINGTON · 2027 plan year

Plan ID H5050-032-000

HMO★ 4.5 CMS Stars
MOOP (in-network)
$6,500
MOOP (combined)
—
Monthly premium
$55/mo
Part C $44.80 + Part D $10.20, before Extra Help
Prescription drugs
Included

This plan in 2026

Plan information

Contract / Plan / Segment
H5050-032-000
Medical deductible
$0 — no deductible
Part D premium
$10.20/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 HEALTH PLAN OF WASHINGTON plans in WA

Benefits & cost sharing

Hospital

BenefitIn-network
Inpatient Hospital — Acute$450/day for days 1–5, $0 after
Inpatient Hospital — Additional Days (Acute)No charge
Inpatient Hospital — Psychiatric$450/day for days 1–5, $0 after
Worldwide Urgent Care Coverage$50

Pharmacy

BenefitIn-network
Part B DrugsSee plan details
Chemotherapy & Radiation Drugs (Part B)0%-20% coinsurance
Other Part B Drugs0%-20% coinsurance

Mental Health

BenefitIn-network
Mental Health Specialty ServicesSee plan details
Mental Health — Individual Sessions$35
Mental Health — Group Sessions$25
Supplemental Health BenefitsSee plan details

Other

BenefitIn-network
Cardiac & Pulmonary RehabilitationSee plan details
Cardiac Rehabilitation — Additional Sessions$35
Intensive Cardiac Rehabilitation — Additional Sessions$35
Pulmonary Rehabilitation — Additional Sessions$15
Supervised Exercise Therapy (SET)$20
Emergency Services$130
Urgently Needed Services$50
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency Coverage$130
Worldwide Emergency Transportation$290
Partial Hospitalization Program$140
Intensive Outpatient Program (IOP)$140
Home Health ServicesNo charge
Primary Care Physician ServicesNo charge
Chiropractic Services$15
Occupational Therapy Services$0-$35
Physician Specialist Services$0-$50
Podiatry Services$50
Other Health Care Professional Services$0-$50
Psychiatric ServicesSee plan details
Psychiatric Services — Individual Sessions$35
Psychiatric Services — Group Sessions$25
Physical Therapy & Speech-Language Pathology$0-$35
Additional Telehealth Services (Part B)No charge
Opioid Treatment Program Services$50
Diagnostic Tests & Lab ServicesSee plan details
Laboratory ServicesNo charge
Radiological ServicesSee plan details
Diagnostic Radiology$375
Therapeutic Radiology20% coinsurance
X-Ray Services$20
Outpatient Hospital Services$0-$450
Hospital Observation Services$0-$450 per stay
Ambulatory Surgical Center (ASC)$450
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual Sessions$35
Substance Abuse — Group Sessions$25
Outpatient Blood ServicesNo charge
Ambulance ServicesSee plan details
Ground Ambulance$290
Air Ambulance$290
Non-Emergency Transportation — Health FacilityNo charge
Durable Medical Equipment (DME)0%-20% coinsurance
Prosthetics & OrthoticsSee plan details
Prosthetic Devices20% coinsurance
Medical Supplies20% coinsurance
Diabetic Supplies & ServicesSee plan details
Diabetic SuppliesNo charge
Diabetic Therapeutic Shoes & InsertsNo charge
Diabetic Monitors0%-20% coinsurance
Dialysis Services20% coinsurance
Medicare-Covered Preventive ServicesSee plan details
Annual Physical ExamNo charge
Smoking & Tobacco Cessation CounselingNo charge
Fitness BenefitNo charge
Remote Access TechnologiesNo charge
Kidney Disease Education ServicesNo charge
Glaucoma ScreeningNo charge
Diabetes Self-Management TrainingNo charge
Digital Rectal ExamsNo charge
Welcome to Medicare EKGNo charge
Insulin (Part B)$35
Dental — Medicare-Covered Services$50
Vision — Eye Exams$0-$50
Vision — Eye ExamsSee plan details
Vision — Routine Eye Exams$0-$50
Vision — EyewearNo charge
Vision — EyewearSee plan details
Vision — Contact LensesNo charge
Vision — Eyeglasses (Lenses & Frames)No charge
Vision — Eyeglass LensesNo charge
Vision — Eyeglass FramesNo charge
Hearing — Exams$0-$50
Hearing — Routine Exams$0-$50
Hearing — Fitting & Evaluation for Hearing AidNo charge
Hearing — ExamsSee plan details
Skilled Nursing Facility (SNF)$0/day for days 1–20, $218/day for days 21–100
Diagnostic Procedures & Tests$20

Service area

  • WA: 4 counties

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