Kaiser Permanente Insurance Review: Why Is It Top-Rated?
Kaiser Permanente Insurance Review: Why Is It Top-Rated?
Kaiser Permanente has consistently received top ratings for its individual insurance and Medicare plans, often ranking far ahead of any competitors. It has a unique model of having insurance and medical care as branches of the same company. This is great for those who want a streamlined experience between health insurance and health care, but these policies are not a good fit for those who want flexibility when choosing their health care providers.
Kaiser Permanente has frequently been named as one of the best health insurance providers in the country.
Both Kaiser's individual and Medicare plans are very well rated, earning between 4 and 5 stars overall, based on their coverage and service. Plus, the company's average rating is consistently higher than many other major insurance companies.
The company only operates in select states, meaning many individuals might not even be able to access these plans. However, if you live in an area where Kaiser operates, these policies could give you great coverage at affordable rates.
The cost of Kaiser insurance varies by policy type. For example, Kaiser's individual and family health insurance plans are usually cheaper than those from other insurers, while its Medicare Advantage plans are often more expensive than other providers.
In both cases, the quality of care you get with Kaiser's integrated system sets it apart from the competition. The insurance coverage directly syncs with Kaiser's hospitals and medical centers. This streamlines your claims and coverage process. It also helps keep Kaiser's costs low so that it can offer you affordable policies.
The downside of Kaiser health insurance is that most plans have no out-of-network coverage except for urgent care or emergencies. If you prefer an insurance plan with more flexibility, then we suggest choosing Anthem or Blue Cross Blue Shield, which is accepted by 90% of doctors across the country.
Where is Kaiser Permanente available?
Kaiser Permanente offers health insurance plans in eight states and the District of Columbia. This includes areas on the West Coast, in the Mid-Atlantic region and more. If Kaiser isn't available in your state, consider one of our other best-rated health insurance companies.
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Kaiser Permanente may only operate in a few states. However, it's still considered a major insurance company because of the significant market share it has in those areas. According to enrollment data, Kaiser is one of the top three largest individual health insurance providers in each state or region where it operates.
Health insurance plan options
Kaiser Permanente offers multiple types of health insurance, including individual plans, family plans, Medicare, Medicaid and group health insurance.
Most Kaiser insurance plans are HMO (health maintenance organization) plans, and this type of health insurance only covers in-network care and generally has cheaper monthly costs. This means your medical benefits are limited to Kaiser's 700 medical offices and 39 hospitals. You're also required to select a primary care physician who can refer you to specialists as needed.
A key concern for those with ongoing health conditions is that this integration between insurance and health care limits your access to specialists who are not affiliated with Kaiser. Keep in mind that Kaiser may have similar providers.
The limited network can also be a problem for frequent travelers. When you're away from home, only urgent care and emergency room services are covered at facilities that are not affiliated with Kaiser. The company also has a dedicated travel line to help you navigate circumstances, coverage or preapproval when you’re traveling to another Kaiser service area or outside of the service area.
Individual and family plans
Kaiser health insurance plans can be purchased through the Health Insurance Marketplace set up by the Affordable Care Act (also called "Obamacare") or directly from the insurance company. However, buying insurance through the marketplace does give you access to health insurance tax credits, which can reduce how much you pay for insurance.
Kaiser Permanente plans include required standard coverages, such as access to free preventive care and screenings, as well as financial protections like an out-of-pocket maximum. Plans are divided into the metal tiers of Bronze, Silver, Gold and Platinum. Kaiser's plans are also classified into the three insurance categories below, so you can choose a Bronze Deductible plan, a Gold Copayment plan or another combination.
- Health savings account (HSA) plans: These high-deductible plans are the cheapest plans offered by Kaiser. They allow you to set up a health savings account so you can avoid paying taxes on the money you'll use to pay for doctor appointments and other health care services.
- Deductible plans: These plans function like traditional insurance where you'll pay for most health services out of pocket until your spending reaches the deductible amount. Then, you’ll pay the coinsurance rate specified by your plan.
- Copayment plans: These Gold and Platinum tier plans have high monthly rates. However, they have no deductible. These policies can help you save money if you expect high medical costs because you'll only pay a copayment for covered services.
Kaiser Permanente also offers Medicare plans, which can be purchased either directly from the company or through Medicare.gov.
- Medicare Advantage (Medicare Part C) plans expand the coverage you get with Original Medicare, adding on more cost-saving benefits and prescription drug benefits. These bundled plans can streamline your health coverage, and Kaiser has been named one of our best Medicare Advantage providers.
- Medicare Advantage Plus plans are how Kaiser classifies its Part C plans that also include coverage for dental care, hearing aids and eyewear.
- Prescription coverage is only available as a part of a bundled Medicare Advantage plan. Stand-alone drug coverage plans (Medicare Part D) are not offered.
Kaiser does not offer Medicare Supplement (Medigap) plans, and those who are looking for these plans can choose from our best Medicare Supplement providers, which include UnitedHealthcare and Aetna.
Medicaid and programs for those with low incomes
Kaiser Permanente also participates in Medicaid programs. For those who qualify for low-income health insurance, the plan issued by your government agency may be through Kaiser.
In addition, Kaiser also offers a Charitable Health Coverage program that provides coverage and access to care for those who are not eligible for public or private health coverage.
There's also a Medical Financial Assistance program that provides free or reduced health care services for those who are low-income, uninsured and underserved.
Employer and group insurance
For group insurance, Kaiser may offer a wider variety of plan options than what's available for individual purchasers. For example, some locations have preferred provider organization (PPO) plans available, which provide broader medical coverage beyond Kaiser's facilities and doctors.
Note that these PPO plans may not be as well-rated as Kaiser's HMO plans. For example, we don't recommend the Kaiser Options PPO plan in Washington state because of its poor customer satisfaction.
Coverage, member resources and unique features
Kaiser Permanente's health coverage stands out in two ways:
- Its integration of health insurance with health care makes it easier for you to track costs and manage claims.
- The strong preventive care program includes access to screenings, health resources, lifestyle programs and health classes.
Depending on your plan, Kaiser's member services may include:
- Women's health services
- Mental health
- Addiction and recovery
- Chiropractic care
- Wellness coaching
- Prescription delivery
- Dental care (add-on)
- Vision care (add-on)
The company's powerful suite of digital tools also stands out from the competition. Plans include:
- Telehealth over phone, video or email
- Online access to health records including test results, doctor's notes and vaccination records
- A cost lookup tool
- The ability to schedule or cancel appointments
- Health insurance management including tracking your deductible
Plus, there are fitness resources including discounted gym memberships, health calculators and discounted massage therapy.
Cost of Kaiser insurance
The monthly cost of Kaiser insurance ranges from about $300 to nearly $1,000 per month based on factors such as the coverage level you choose and your age.
Average monthly cost of Kaiser Permanente insurance
Based on available policies in California.
Keep in mind that these base rates are for individuals paying full price for health insurance. Health insurance subsidies through the Affordable Care Act (ACA) can help reduce your monthly insurance bills, and you can qualify for these health insurance discounts based on your income and family size.
Kaiser health insurance is usually cheaper than other major insurance companies such as Blue Cross Blue Shield.
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|Anthem Blue Cross||$517|
Average monthly cost of a Silver plan for a 40-year-old in California.
The cost of Kaiser health insurance also changes by location. States are priced individually, but there are some regional trends on the West Coast. California, Washington and Oregon have similarly priced plans, with Oregon having the cheapest rates of the three. On the East Coast, costs change more between the neighboring states of Virginia and Maryland.
A 40-year-old could pay 41% more each month to get Kaiser insurance in Virginia than they would in Maryland. Some of this difference is due to overall pricing trends in the two states.
Where is Kaiser Permanente the cheapest?
Kaiser Permanente health insurance has the lowest average prices in Maryland, with a Silver plan costing an average of $335 per month.
Average cost for a 40-year-old purchasing a Silver plan.
Customer reviews and complaints
Kaiser Permanente receives top-tier scores across several different metrics, showing that it's a company that provides strong coverage and great customer service.
How satisfied are existing customers?
According to J.D. Power, Kaiser Permanente scored as the No. 1 insurance company for health insurance customer satisfaction in all of its locations where plans were ranked. In a separate J.D. Power study of Medicare Advantage customers, Kaiser also ranked as the top company for customer satisfaction.
The consistency of these ratings shows that consumers are happier overall with Kaiser Permanente than with other health insurers.
How are Kaiser's plans ranked?
As to overall plan rankings, Kaiser Permanente is very highly rated for both its individual and Medicare Advantage plans, with nearly all plans having between 4 and 5 stars on HealthCare.gov or Medicare.gov. The one exception is the PPO health insurance plan in Washington state, called Kaiser Options, which has a lackluster rating of 3.5 stars.
Policyholders have said they appreciate the convenience of having all aspects of health care available within the Kaiser facilities.
Does Kaiser Permanente get many complaints?
Kaiser also has a good rating from the National Association of Insurance Commissioners (NAIC), scoring an average of 0.24 on the complaint index, which means it receives 76% fewer complaints than a typical company of its size.
The most common complaint is claim handling delays. While delays are not ideal, other large insurance companies can have a high rate of claim denials, which is more problematic.
What are the reviews of Kaiser Permanente's doctors and medical care?
In California, Kaiser Permanente received an average of 4.5 stars out of 5 for the quality of medical care, according to the state report card. This is much better than the 3.1-star statewide average for health insurance plans.
However, Kaiser only received 2.5 stars for the overall patient experience. This is low, but it matches the statewide average for all insurers, indicating that patients are often not satisfied with their experience, regardless of insurer.
Note that policyholders in some locations have reported that it's difficult to access mental health care at some Kaiser facilities, which the company says is due to staffing shortages.
What do Medicare Advantage policyholders say?
Survey data collected by Medicare reveals that Kaiser's Medicare Advantage policyholders are very happy with their coverage, their ability to get prescriptions and the quality of their health care. In contrast, enrollees give the company lower ratings for their ability to get health care and coordination of care, such as follow-ups after tests.
Kaiser Permanente star rating
National average rating
|Rating of drug plan||5.0||3.4|
|Getting needed prescription drugs||5.0||3.5|
|Rating of health plan||4.9||3.4|
|Rating of health care quality||4.6||3.5|
|Getting appointments and care quickly||4.1||3.8|
|Getting needed care||3.4||3.6|
National average of Medicare Advantage policyholder surveys via Medicare.gov.
Frequently asked questions
Is Kaiser a good insurance company?
Yes, Kaiser Permanente is a good health insurance company, earning top scores for customer satisfaction, preventive care and overall plan experience.
Does Kaiser have HMO plans or PPO plans?
Most Kaiser health insurance plans are HMO plans, meaning you'll generally have lower monthly costs, but your health coverage is limited to in-network doctors and facilities. Some PPO plans may be available, but these are generally not as well-rated as Kaiser's HMO plans.
How much is Kaiser insurance per month?
The average monthly cost of insurance from Kaiser Permanente will heavily depend on your state of residence. For example, Kaiser rates for health insurance range from $335 in Maryland to $474 in California. For those purchasing insurance on the marketplace, the amount you pay may be reduced because of health insurance subsidies.
Does Kaiser offer "Obamacare" insurance plans?
Yes, you can buy Kaiser Permanente insurance from the "Obamacare" Health Insurance Marketplace. Kaiser plans are not available nationwide and are only available to those who live in the states where the company operates.
Can I add dental to my Kaiser health insurance?
Yes, you can add dental insurance to your Kaiser medical insurance during open enrollment. Depending on your location and situation, you can either sign up directly through Kaiser Permanente or by choosing a dental plan listed on the marketplace.
Methodology and sources
Cost comparisons were developed using 2022 public use files from the Centers for Medicare and Medicaid Services (CMS). Calculations were based on provider, location, age and plan tier. Ranking data was sourced from separate CMS public use files.
Additional sources include provider marketing material, HealthCare.gov, Medicare.gov, J.D. Power, the Kaiser Family Foundation, the National Committee for Quality Assurance (NCQA) and the State of California's Office of the Patient Advocate.
The National Association of Insurance Commissioners (NAIC) average complaint score is based on a weighted average of all subsidiaries based on total premiums.
Editorial Note: The content of this article is based on the author’s opinions and recommendations alone. It has not been previewed, commissioned or otherwise endorsed by any of our network partners.