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.
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.
- 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.
- Paper election forms
You can submit paper election forms to KPWA in 3 ways:
- By mail to Kaiser Permanente – Medicare Unit
P.O. Box 232400
San Diego, CA 92193-2400 - By fax to 1-855-355-5334
- 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.
- By mail to Kaiser Permanente – Medicare Unit
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
- Centennial, Columbia, Essential, Harbor, Key, Optimal, Vital (HMO)
Provider network: Medicare Advantage HMO IND Part D - Anchor (HMO)
Provider network: Medicare Advantage HMO Anchor IND Part D - Basic (HMO)
Search online directory: Medicare Advantage HMO Individual
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
Certifications and Commissions
Completion of the annual Kaiser Permanente Washington Medicare certification program is required to represent our Medicare health plans.
Learn more
2024 Forms and Resources
Enrollment Form (PDF)
Guide to Medicare (PDF)
Pre-Enrollment Checklist (PDF)
Service Area Map (PDF)
Silver&Fit Flyer (PDF)
Star Rating (PDF)
Transportation Flyer (PDF)