Questions and answers about your Medicare health plan coverage changes

Why do I have to enroll in a Medicare health plan for individuals?
Your employer, union, or trust fund made the difficult decision to cancel group sponsored Medicare health plan coverage for its Medicare retirees. We want to help you keep the Kaiser Permanente coverage and care you’ve come to rely on. To do this, you will need to enroll in a Kaiser Permanente Medicare health plan for individuals.

What are my Medicare health plan choices with Kaiser Permanente?
We offer several Medicare health plans for individuals. To speak to a Kaiser Permanente Medicare specialist who can guide you through our plans and help you make the choice that’s right for you, call 1-877-231-4833 (toll free) (TTY 711), 8 a.m. to 8 p.m., 7 days a week. You can also see plan benefits on kp.org/medicare.

What’s covered under the Medicare health plan for individuals?
Our Medicare health plans for individuals will be different from your current Medicare group coverage. You should have received Your Guide to Keeping Your Kaiser Permanente Medicare Health Plan in the mail, as well as benefit and cost information that explains your new benefits and coverage.

But even as your plan changes, many things will stay the same. You’ll continue to enjoy the benefits of being a Kaiser Permanente member, with one plan giving you hospital care, medical services, and, with most plans, prescription drugs.

Do I get to stay with my health care team?
Absolutely! You can stay with your health care team and get the same quality service and convenience you’ve come to count on.

Does Kaiser Permanente offer any supplemental benefits such as dental, vision, or hearing?
You may have some options for supplemental benefits. Information about supplemental benefits will be included in the benefit and cost information that Kaiser Permanente will be sending you.

You can also call one of our Kaiser Permanente Medicare specialists to talk about specific benefits and costs.

If you have a reimbursement account, such as a health reimbursement arrangement (HRA), you may be eligible for reimbursement of these supplemental benefit premiums. Be sure and check with your benefits administrator about what expenses are eligible.

Do I need to enroll in prescription coverage?
Most Kaiser Permanente Medicare health plans for individuals include prescription drug coverage, and you can enroll in one of these plans. Please be aware that you may only enroll in one Medicare health plan with Part D prescription drug coverage at a time. If you are enrolling in a Part D plan outside of Kaiser Permanente, your enrollment with Kaiser Permanente Medicare health plan for individuals may be discontinued.

Does the Medicare health plan for individuals cover specialists?
Yes. When you need specialized care, your personal doctor will help you find the right specialist.

How much does the Medicare health plan for individuals cost?
Please watch your mail for the Individual Kaiser Permanente Medicare health plan benefit and cost information. You can also call us to learn about specific costs for Medicare health plan for individuals. Be sure to ask how the new plan may save you money.

How can I pay for the Medicare health plan for individual’s premium?
You will receive information directly from Kaiser Permanente on how to pay your monthly plan premium. There are several options: you can pay by mail, or you can set up monthly payments from your bank account.

You and your Medicare eligible dependents may be able to use funds from a Health Reimbursement Account (HRA), Retirement Reimbursement Account (RRA) or subsidy to help pay for premiums and approved medical costs with your new individual plan. Information about your financial options should be available in the transition materials provided to you from your employer. Please contact the benefits administrator directly to discuss options that may be available, based on your eligibility.

How does the new plan affect my health reimbursement arrangement (HRA) and/or Retirement Reimbursement Account (RRA)?
The HRA/RRA benefits administrator does not enroll Kaiser Permanente members. However, most of the time, retirees can remain a Kaiser Permanente member and still get a reimbursement, if available based on eligibility, from their HRA/RRA. For Kaiser Permanente members, the benefits administrator’s only role is administering the HRA/RRA.

Any questions regarding this HRA/RRA account and how it works with your Medicare health plan for individuals will be answered by the benefits administrator.

Some key questions you may want to ask the HRA/RRA benefits administrator are listed below:

• Do I qualify for an HRA/RRA? If yes, how much?
• Will I receive the same amount every year, or is there an end date?
• What exactly can I use my reimbursement funds towards, for example, premiums such as Medical/ Hospitalization/ Dental/ Vision/ Medicare Part B? Copays such as Medical/ Hospitalization/ Dental/ Vision/ Medicare Part B?
• If I don’t use all of my reimbursement funds in the current year, does the balance roll over to the next year, or do I lose it?
• Does my spouse qualify? If yes, how much? Can my reimbursement funds be combined with my spouse to form a joint account or must they remain separate?
• What type of documentation do I need to provide to the administrator to get reimbursements and how often?
• Is there anything else I need to know about my reimbursement account?

Will there be a gap in my coverage or care?
Because your group has chosen to cancel Medicare health plan coverage, you will need to enroll in a Kaiser Permanente Medicare health plan for individuals to continue your coverage with Kaiser Permanente.

Ask your employer or trust fund's benefits administrator about your specific enrollment period. Generally, you can enroll in the Medicare individual health plan no earlier than 90 days before your group coverage ends.

The sooner you enroll, the sooner you can relax knowing your Kaiser Permanente coverage will continue without any gap in service, allowing you to keep any appointments you already have scheduled.

Will my Health/Medical Record number change?
No, your Health/Medical Record number will stay the same.

Can I use my current ID card for the Medicare health plan for individuals?
After you enroll, we’ll send you a new Kaiser Permanente ID card.

If you need care after you’ve enrolled in the new plan but before your ID card arrives, use your old ID card. Your Health/Medical Record number and other medical record information will not change.

Can my spouse or other dependents join too?
Absolutely! As long as your spouse is eligible for Medicare and lives within the Kaiser Permanente Medicare health plan for individuals service area. Call us to learn more and enroll your spouse if he or she is eligible.

If you have dependents that aren’t Medicare eligible, contact your benefits administrator to verify and understand options for continued coverage for your Non-Medicare eligible dependents.

Kaiser Permanente also offers non-Medicare health plans for individuals. If you have any questions, please call 1-877-297-0584 (toll free) (TTY 711) 8 a.m. to 8 p.m., 7 days a week.

What do I need to do to sign up?
First, determine your group’s specific enrollment period.

You may choose one of the following 3 ways to enroll in a Kaiser Permanente Medicare health plan for individuals:

• Fill out the enrollment form that will arrive in the mail. You must complete the enrollment form and return it to Kaiser Permanente, by the date specified, to avoid a lapse in coverage as you transition from your old group plan to your new individual plan. To help ensure your enrollment into the Kaiser Permanente Medicare health plan for individuals goes as smoothly as possible, please be sure to indicate on your enrollment form, or to our Kaiser Permanente Medicare specialist, the date your employer sponsored coverage will end.
• Enroll online or download our enrollment form and either email or fax it back to us.
• Call 1-877-231-4833 (toll free) (TTY 711), 8 a.m. to 8 p.m., 7 days a week, to speak with a Kaiser Permanente Medicare specialist and enroll over the phone.

Remember, you can apply for a Medicare health plan for individuals up to 90 days before your group coverage ends. In order to avoid any gap in coverage, you will need to request that your new Medicare health plan for individuals begins the day after your group coverage ends.

I got an offer for Medicare coverage from another health plan. What should I do?
Call one of our Kaiser Permanente Medicare specialists at any time to learn all the reasons to stay with Kaiser Permanente.

I have more questions. Who do I call?
Call 1-877-231-4833 (toll free) (TTY 711), 8 a.m. to 8 p.m., 7 days a week. Our Kaiser Permanente Medicare specialists understand the details of your employer’s coverage termination and will help make the transition to a Kaiser Permanente Medicare health plan for individuals easy for you.