Medicare Advantage

Our high quality Medicare Advantage (HMO) health plans combine both care and coverage. As a care provider and a health plan, we work to ensure our mutual clients have the best experience, both as plan members and as patients.

Learn more about representing our plans.

Quote and enroll KPWA Medicare health plans online. Learn more

Get Sales Packets

Submit your request and you should receive packets within 5 to 7 business days.

Washington market

Kaiser Foundation Health Plan of Washington offers individual Medicare Advantage (HMO) plans in the following Washington state counties: Island, King, Kitsap, Lewis, Pierce, Skagit, Snohomish, Spokane, Thurston, Whatcom and partial counties Grays Harbor and Mason.1

Medicare Advantage Prescription Drug (MAPD) plans

Puget Sound

The Puget Sound service area consists of King, Kitsap, Lewis, Pierce, Snohomish, and Thurston counties, and parts of Grays Harbor and Mason counties.1

Kaiser Permanente Medicare Advantage Key (HMO)2
Kaiser Permanente Medicare Advantage Vital (HMO)
Kaiser Permanente Medicare Advantage Essential (HMO)
Kaiser Permanente Medicare Advantage Optimal (HMO)

North

The North service area consists of Island, Skagit, and Whatcom counties.

Kaiser Permanente Medicare Advantage Key (HMO)2
Kaiser Permanente Medicare Advantage Anchor (HMO)3
Kaiser Permanente Medicare Advantage Harbor (HMO)

Spokane

The Spokane service area consists of Spokane County.

Kaiser Permanente Medicare Advantage Centennial (HMO)
Kaiser Permanente Medicare Advantage Columbia (HMO)

Medicare Advantage (MA-Only) plan

Available in all of Kaiser Permanente Washington’s Medicare Advantage service area.

Medicare Advantage Basic (HMO)4

1 Grays Harbor County service area ZIP codes: 98541, 98557, 98559, 98568. Mason County service area ZIP codes: 98524, 98528, 98546, 98548, 98555, 98584, 98588, 98592.
2 The Key plan is only available in King, Kitsap, Island, Pierce, Snohomish, and Thurston counties.
3 The Anchor plan is only available in Skagit and Whatcom counties.
4 The Basic (HMO) plan does not include Medicare Part D prescription drug coverage and cannot be combined with a stand-alone Part D prescription drug plan (PDP). Without Medicare prescription drug coverage, or creditable prescription drug coverage (as good as Medicare’s) such as TRICARE or VA, the Medicare beneficiary may have to pay a late enrollment penalty if they enroll in Medicare prescription drug coverage in the future.

Medicare Sales Producer Support

The Medicare Sales Producer Support team is available to answer questions regarding the following topics:

  • Medicare Certification and Training
  • Book of Business questions
  • Client eligibility
  • Client enrollment status
  • Plan quotes and benefits
  • Sales kit requests
  • Producer of Record changes
  • Online quoting

KPWA Medicare Sales Producer Support team

Phone: 1-800-581-8252, Monday through Friday, 8:30 a.m. to 5 p.m.

Email: KPWA.Medicare@kp.org (Please do not send Medicare Advantage elections forms to this email address.)

To learn more about our Medicare Advantage plans and market, unique care model, and organizational values check out our on-demand supplemental agent training. (Please note, this training does not replace the required annual Medicare certification training through Miramar:Agent.)

Producer Relations

  • Appointment updates
  • Name, email, or address change
  • Producer addition or termination
  • Merger or acquisition
  • Commission payment or statement inquiry
  • Producer Portal access

Producer Relations Line:

Phone: 1-800-337-3196

  • Press 1 for commissions and appointments.
  • Press 2 for producer website questions.

Email: brokerappt.commission@kp.org

Medicare Member Services

Some inquiries may require member authorization to release information.

  • Claims status and appeal
  • Coordination of benefits
  • Identification card
  • Medicare coverage
  • Member address change
  • Member billing and payments
  • Member benefits
  • Outpatient fee quotes
  • Provider network
  • Primary care physician selection or change

Medicare Member Services:

Phone: 1-888-901-4600 (TTY 711). Representatives available:

  • April 1 through September 30: Monday through Friday, 8 a.m. to 8 p.m.
  • October 1 through March 31: 7 days a week, 8 a.m. to 8 p.m., except major holidays.

Quoting and Enrollment Submission

Medicare Advantage enrollment can be submitted either online or via a paper Election form.

  1. Online enrollment through SunFire

    This is the preferred method of submission for both timeliness and accuracy. Use your KPWA SunFire account to document scope of appointments, send quotes, share your Personal URL, record marketing and sales calls and complete your client’s enrollment online.

  2. Paper election forms

    You can submit paper election forms to KPWA in 3 ways:

    1. By mail to Kaiser Permanente – Medicare Unit
      P.O. Box 232400
      San Diego, CA 92193-2400
    2. By fax to 1-855-355-5334
    3. By email to KPMedicareEnrollments@kp.org

      Enrollment forms submitted via email must be encrypted. If you’re unable to meet this email requirement, please use one of the alternate forms of submission listed above.

Note that Election forms must be submitted to KPWA within 24 hours of receipt by the agent.

Plan Resources

Plan Documents

  • Summary of Benefits

  • Evidence of Coverage

  • Annual Notice of Changes

  • Provider and pharmacy directories and more

Pharmacy and Formulary

  • Part D Formulary
  • Pharmacy directory
  • Mail-order and Rx refills
  • Medicare Medication Therapy Management (MTM) Program
  • Extra Help Premium Summary and more

Mail-order pharmacy

1-800-245-7979 (TTY 711), Monday through Friday, 7:30 a.m. to 7 p.m., Saturday and Sunday, 8 a.m. to 4:30 p.m.

Part D Rx claims processing

Mail request for payment of Part D drugs together with any bills or receipts to us at this address:

OptumRX
P.O. Box 650287
Dallas, TX 75265-0287

Online Provider Search

Member Support Center

Premium payment options

Mail:
Kaiser Foundation Health Plan of Washington
P.O. Box 740008
Los Angeles, CA 90074-0008

Online:
kp.org/wa/mypremium

Phone:
1-844-632-2045 (24/7)
1-866-537-6133 (Monday through Friday, 8 a.m. to 8 p.m.)

Medical claims processing

Mail requests for payment of medical care together with any bills or paid receipts to us at this address:

Kaiser Permanente
P.O. Box 30766
Salt Lake City, UT 84130-0766

Appeals for medical care or Part D prescription drugs

Kaiser Permanente
Medicare Appeals Coordinator
P.O. Box 34593
Seattle, WA 98124-1593