Kaiser Foundation Health Plan of Washington Medicare Advantage HMO Plans

Puget Sound Rates and Benefits

Medicare Advantage Basic (HMO)
Medicare Advantage Vital (HMO)
Medicare Advantage Essential (HMO)
Medicare Advantage Optimal (HMO)
Medicare Advantage Group Retiree (HMO)
Plans available in King, Kitsap, Lewis, Pierce, Snohomish, and Thurston counties, and parts of Grays Harbor and Mason counties.1

Northwest Counties Rates and Benefits

Medicare Advantage Basic (HMO)
Medicare Advantage Harbor (HMO)
Medicare Advantage Group Retiree (HMO)
Plans available in Island, San Juan, Skagit, and Whatcom counties.

Spokane County Rates and Benefits

Medicare Advantage Basic (HMO)
Medicare Advantage Centennial (HMO)
Medicare Advantage Columbia (HMO)
Medicare Advantage Group Retiree (HMO)

Medicare Advantage Part D Comprehensive Formulary (PDF)

Medicare Advantage HMO Dental Benefits (PDF)

HMO Service Area (PDF)

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 Forms

Advantage Plus Dental Flyer (PDF)

Evidence of Coverage (MAPD) (PDF)

Evidence of Coverage - Basic (MA) (PDF)

OTC Wellness Benefit Flyer (PDF)

Service Area Map (PDF)

Transportation Flyer (PDF)

Summary of Benefits - Key (HMO) (PDF)

Summary of Benefits - Basic (HMO) (PDF)

Star Rating (PDF)

Advantage Plus Dental Brochure (PDF)

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

Summary of Benefits - Harbor and Anchor (HMO) (PDF)

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

Silver&Fit Flyer (PDF)

Guide to Medicare (PDF)

Benefits Highlights Chart - Puget Sound (PDF)

Benefits Highlights Chart - North (Skagit and Whatcom) (PDF)

Benefits Highlights Chart - North (Island) (PDF)

Benefits Highlights Chart - Basic (PDF)

Benefits Highlights Chart - Spokane (PDF)

Medicare Advantage Quoting Tool and Online Application Guide (PDF)

Star Rating Flyer (PDF)

Benefits at a Glance – North (PDF)

Benefits at a Glance – Puget Sound (PDF)

Benefits at a Glance – Spokane (PDF)

Silver and Fit Flyer (PDF)

Service Area Map (PDF)

Pre-Enrollment Kit Baseline Cover Letter (PDF)

Pre-Enrollment Checklist (PDF)

OTC Wellness Benefit (PDF)

Medicare Advantage HMO Optional Dental Benefits (PDF)

Scope of Appointment Form (PDF)

Guide to Medicare (PDF)

Plans and Benefits Spokane Booklet (PDF)

Plans and Benefits Puget Sound Booklet (PDF)

Plans and Benefits North Booklet (PDF)

2022 Plans and Benefits North Booklet (PDF)

2022 Plans and Benefits Puget Sound Booklet (PDF)

2022 Plans and Benefits Spokane Booklet (PDF)

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)

Plan Summary Worksheet (PDF)

2021 Pre-enrollment kit baseline cover letter (PDF)

Silver & Fit Flyer (PDF)

Star Rating Flyer (PDF)

KPIF and Medicare Sales Contact Sheet (PDF)

Annual Notice of Change - Basic plan (PDF)

Annual Notice of Change - Essential plan (PDF)

Annual Notice of Change - Harbor plan (PDF)

Annual Notice of Change - Optimal plan (PDF)

Annual Notice of Change - Vital plan (PDF)

Annual Notice of Change - Centennial plan (PDF)

Annual Notice of Change - Columbia plan (PDF)


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