Medicare Advantage

Our 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 a plan member and a patient.

Completion of the Kaiser Permanente Washington Medicare 2021 certification program is required to represent our Medicare health plans during the Annual Enrollment Period (AEP).
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Email us with your request and you should receive packets within 5 to 7 business days.

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Kaiser Foundation Health Plan of Washington Medicare Advantage HMO Plans

Puget Sound Region Plans and Benefits (PDF)

Plans available in King, Kitsap, Lewis, Pierce, Snohomish, and Thurston counties, and parts of Grays Harbor and Mason counties.1

Medicare Advantage Vital (HMO) - $28 per month
Medicare Advantage Essential (HMO) - $99 per month
Medicare Advantage Optimal (HMO) - $295 per month
Medicare Advantage Basic (HMO) No Part D - $40 per month

Only available in King, Pierce, Snohomish, and Thurston Counties

Medicare Advantage Key (HMO) – $0 per month

Northwest Counties Plans and Benefits (PDF)

Plans available in Island, Skagit, and Whatcom counties.
Medicare Advantage Harbor (HMO) - $48 per month
Medicare Advantage Basic (HMO) No Part D - $40 per month
Medicare Advantage Anchor (HMO) - $0 per month - Whatcom and Skagit counties only
Medicare Advantage Key (HMO) - $0 per month - Island county only

Spokane County Plans and Benefits (PDF)

Plans available in Spokane County.
Medicare Advantage Centennial (HMO) - $0 per month
Medicare Advantage Columbia (HMO) - $48 per month
Medicare Advantage Basic (HMO) No Part D - $40 per month

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.

Puget Sound Region Plans and Benefits (PDF)

Plans available in King, Kitsap, Lewis, Pierce, Snohomish, and Thurston counties, and parts of Grays Harbor and Mason counties.1

Medicare Advantage Vital (HMO) - $28 per month
Medicare Advantage Essential (HMO) - $99 per month
Medicare Advantage Optimal (HMO) - $295 per month
Medicare Advantage Basic (HMO) No Part D - $40 per month

Only available in King, Pierce, and Thurston Counties

Medicare Advantage Key (HMO) – $0 per month

Northwest Counties Plans and Benefits (PDF)

Plans available in Island, Skagit, and Whatcom counties.
Medicare Advantage Harbor (HMO) - $85 per month
Medicare Advantage Basic (HMO) No Part D - $40 per month

Spokane County Plans and Benefits (PDF)

Plans available in Spokane County.
Medicare Advantage Centennial (HMO) - $0 per month
Medicare Advantage Columbia (HMO) - $99 per month
Medicare Advantage Basic (HMO) No Part D - $40 per month

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.

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 Tool

Medicare Sales Producer Support can be reached at 1-800-581-8252 or via email at KPWA.Medicare@kp.org.

Note: Please do not send Medicare Advantage elections forms to this email address.

Kaiser Permanente Medicare Advantage Quotes and Enrolling

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

  1. Online enrollment through the Agent Quoting Tool

    This is the preferred method of submission for both timeliness and accuracy. You can either assist your clients in completing their enrollment online through our producer Quoting Tool, or by sending them your individual sales URL, where they complete their enrollment.

  2. Paper election forms

    You can submit paper elections form to KPWA 3 ways:

    1. By mail to Kaiser Permanente Medicare Enrollment
      PO Box 232407
      San Diego, CA 92193-9914
    2. By Fax to 1-855-355-5334
    3. By encrypted email to KPWA.medicaremembership@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.

Sales Resources

Provider Network

Kaiser Permanente doctors and providers

Formulary

Medicare Advantage (HMO) Part D drug formulary

Plan Documents

Annual Notice of Change, Evidence of Coverage, and Summary of Benefits

Medicare Advantage Group Retirees

For information on Group Retiree plans, contact Large Group Sales and Account Management.

For 2020 Medicare forms please visit our Forms and Resources page.

Certifications and Commissions

The Medicare Certification period for plan year 2021 began August 18, 2020. More information on certifications or selling our Medicare Advantage plans can be found here.

2021 Medicare Forms

2021 Plans and Benefits Spokane (PDF)

2021 Plans and Benefits North (PDF)

2021 Plans and Benefits Puget Sound (PDF)

Scope of Appointment Form (PDF)

Star Rating Flyer (PDF)

Summary of Benefits Basic (HMO) (PDF)

KPIF and Medicare Sales Contact Sheet (PDF)

Enrollment Form (PDF)

Summary of Benefits Anchor (HMO) (PDF)

Plan Summary Worksheet (PDF)

2021 Pre-enrollment kit baseline cover letter (PDF)

Medicare Advantage HMO Optional Dental Benefits (PDF)

Service Area Map (PDF)

Summary of Benefits Vital, Essential, Optimal (HMO) (PDF)

Summary of Benefits Harbor (HMO) (PDF)

Summary of Benefits Centennial and Columbia (HMO) (PDF)

Summary of Benefits Key (HMO) (PDF)

Silver&Fit Flyer (PDF)