Kaiser Permanente (Kaiser) is an example of a Medicare Advantage (Part C) plan provider that offers dental services.
Medicare covers many health-related services, but this usually excludes dental procedures.
If a person needs dental treatments, they may need to get additional dental coverage or enroll in a Medicare Advantage plan that offers dental benefits.
This article explores Kaiser’s plans, including the dental benefits. It also looks at coverage and costs.
Glossary of Medicare Terms
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Kaiser is based in California and includes the Kaiser Foundation Health Plan, the Permanente Medical Groups, and the Kaiser Foundation Hospitals and their subsidiaries.
The nonprofit health plan currently operates in eight states and the District of Columbia. As of 2024, an estimated 12.6 million people were enrolled in the Kaiser health plans.
The Centers for Medicare and Medicaid Services (CMS) rate Medicare Advantage (Part C) plans using a 5-star system, with 5 stars being the highest rating.
For 2024, more than 20 Medicare Advantage plans got 5-star ratings, and Kaiser was represented in six plans nationwide. These were:
- Kaiser Foundation HP (California)
- Kaiser Foundation HP of Colorado
- Kaiser Foundation HP of Georgia, Inc.
- Kaiser Foundation HP (Hawaii)
- Kaiser Foundation Health Plan of the Mid-Atlantic (Washington D.C., Maryland, and Virginia)
- Kaiser Foundation HP of the NW (Oregon and Washington)
Considerations for star ratings include customer service, care coordination, screenings, coverage, and timely decisions regarding coverage appeals.
In 2024, Kaiser offers services in the following regions:
- California (Northern and Southern)
- Colorado
- Georgia
- Hawaii
- Mid-Atlantic states (Northern Virginia, Maryland, and Washington D.C.)
- Washington (Central, Eastern, Puget Sound, and Coastal)
- Northwest (Certain areas of Oregon and Washington)
Most of the company’s plans are Health Maintenance Organization (HMO) plans, which means enrollees need to use the plan’s in-network doctors and healthcare facilities.
Kaiser also offers some Special Needs Plans (SNPs), which aim to help people with certain health or financial needs.
Learn more about Medicare Advantage (Part C).
Two plan types include dental coverage: the Kaiser Permanente Senior Advantage Basic (HMO) and the Kaiser Permanente Senior Advantage Enhanced (HMO).
Both plans include the following preventive and diagnostic dental services:
- two oral exams
- two teeth cleanings
- two X-rays per calendar year
The table below outlines some 2024 costs for these plans:
| Benefits | Basic plan | Enhanced plan |
|---|---|---|
| Monthly Premium | $0 | $20 |
| Deductible | $0 | $0 |
| Dental | • $0 for preventive services, including two exams, cleanings, and X-rays per year • $0 to $580 (or 75% coinsurance) for specialized services | • $0 for preventive services, including two exams, cleanings, and X-rays per year • $0 to $580 (or 75% coinsurance) for specialized services |
| Maximum out-of-pocket costs | $5,900 | $3,900 |
Comprehensive coverage
In many areas, Kaiser offers an option of additional coverage known as Advantage Plus, which incurs an additional monthly premium of $9 but provides comprehensive dental care. Comprehensive dental care benefits vary by region.
There may be additional costs, depending on the service the person uses. People can check this using the company’s Evidence of Coverage document.
Medicare Advantage (Part C) is an alternative to Original Medicare and offers the same basic coverage. Some plans may also offer additional benefits, such as dental, hearing, and vision coverage. Some plans also include prescription drug coverage.
Private health insurance companies offer these plans, though a person will continue to pay their Medicare Part B premium, which is $174.70 per month in 2024. There may also be an additional Medicare Advantage plan premium, depending on the individual plan a person chooses.
Read more about Original Medicare vs. Medicare Advantage.
Kaiser’s Medicare Advantage plan costs vary by region. A person can use this online tool to research the plans.
The costs for supplemental dental insurance and copays vary, and some Kaiser plans do not offer dental coverage. The table below provides more detail:
| Location | Plan | Premium | Dental coverage | Maximum cost for health services |
|---|---|---|---|---|
| Atlanta, Georgia Zip 30301 | Kaiser Permanente Senior Advantage Basic (HMO) | $0 | preventive and comprehensive (with limits) | $5,900 in-network |
| Los Angeles, California Zip 90005 | Kaiser Permanente Senior Advantage LA, Orange Co. (HMO) | $0 | preventive and diagnostic | $1,999 in-network |
| Honolulu, Hawaii Zip 96815 | Kaiser Permanente Senior Advantage Basic (HMO) | $29 | preventive and diagnostic | $8,050 in-network |
| Washington D.C. Zip 20001 | Kaiser Permanente Medicare Advantage Value DC (HMO-POS) | $0 | preventive, diagnostic, comprehensive (with limits) | $6,900 in-network |
| Denver, Colorado Zip 80014 | Kaiser Permanente Senior Advance Core DM (HMO) | $0 | preventive, diagnostic, comprehensive | $3,900 in-network |
| Olympia, Washington Zip 98501 | Kaiser Permanente Medicare Advantage Key (HMO) | $0 | preventive and diagnostic | $6,600 in-network |
| Portland, Oregon Zip 97035 | Kaiser Permanente Senior Advantage Value (HMO-POS) | $0 | none | $5,000 in-network |
Some plans may require an additional monthly premium in order to add comprehensive dental coverage. Individuals need to check the plan closely when choosing.
Kaiser’s Medicare Advantage plans offer basic or comprehensive dental coverage.
Before selecting a Kaiser dental plan, a person needs to check that their dental provider accepts it to ensure the greatest cost savings.
Plan premiums may vary according to a person’s region and the services they use.
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.