Health Insurance

Kaiser Permanente Insurance Review: Why Is It Top-Rated?

Kaiser Permanente Insurance Review: Why Is It Top-Rated?

Editor's Rating

Consistently high-rated insurance plans are available in select states.

Good for

  • Those who want top-tier customer service and coverage.
  • Those who want access to Kaiser's medical specialists.
  • Healthy people who want strong preventive coverage.

Bad for

  • Residents outside of coverage areas.
  • Those who want the flexibility to see any doctor.
  • Frequent travelers who want routine care anywhere.
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Editor's Rating

Consistently high-rated insurance plans are available in select states.

Good for

  • Those who want top-tier customer service and coverage.
  • Those who want access to Kaiser's medical specialists.
  • Healthy people who want strong preventive coverage.

Bad for

  • Residents outside of coverage areas.
  • Those who want the flexibility to see any doctor.
  • Frequent travelers who want routine care anywhere.
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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.

Our thoughts

Kaiser Permanente has frequently been named as one of the best health insurance providers in the country. Rankings on both HealthCare.gov and Medicare.gov give plans 4 to 5 stars, which 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 is average, and they're not the cheapest insurance plans available. However, 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 BlueCross BlueShield, 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 Pacific 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.

Kaiser insurance availability map

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 location where it operates.

Health insurance plan options

Kaiser Permanente offers health insurance for all categories of consumers. That includes individual/family, Medicare, Medicaid and group health insurance.

Most Kaiser insurance plans are health maintenance organization (HMO) 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 who are also well-rated.

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 (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 each month for insurance.

All plans conform to health insurance regulations, giving you access to free preventive care and screenings, as well as having financial protections like an out-of-pocket maximum. Plans are divided into the metal tiers of Bronze, Silver, Gold and Platinum. They're also classified into the three insurance categories below, so you can choose a Bronze Deductible plan, a Gold Copayment plan or another combination.

  1. 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.
  2. 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.
  3. Copayment plans: These Gold and Platinum tier plans have high monthly premiums. 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.

Medicare

Kaiser Permanente also offers Medicare plans, which can be purchased either directly from the company or through Medicare.gov.

Plan options:

  • 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 drug plans (Medicare Part D) are stand-alone plans for those not signing up for a Medicare Advantage plan. Kaiser also excels in this category, and it has been named one of our best Medicare Part D providers.

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 administered by 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:

  1. Its integration of health insurance with health care makes it easier for you to track costs and manage claims.
  2. 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 more than $1,000 per month based on factors such as your age and plan coverage level.

Average monthly cost of Kaiser Permanente insurance

Metal tier
Age 21
Age 40
Age 60
Bronze$292$373$791
Silver$364$464$986
Gold$415$529$1,123
Platinum$456$583$1,237

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.

The cost of Kaiser health insurance is usually about average when compared to all other insurance providers, but it's cheaper than other major insurance companies such as BlueCross BlueShield.

Monthly cost of Kaiser health insurance

The cost of Kaiser health insurance also changes by location. 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, there is a significant cost difference between the neighboring states of Virginia and Maryland. A 40-year-old could pay 54% 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?

State
Monthly cost
Maryland$351
Colorado$397
Oregon$429
Washington$443
California$464
Hawaii$481
Georgia$487
Virginia$539

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.

Kaiser Permanente rankings
  • No. 1 in customer satisfaction
  • 4 to 5 stars individual/family health insurance
  • 4 to 5 stars overall performance (except Washington PPO)
  • 4.5 to 5 stars Medicare Part D coverage
  • 4 to 5 stars Medicare Part C coverage
  • 23% fewer complaints than average

According to J.D. Power, Kaiser Permanente scored as the No. 1 insurance company for customer satisfaction in each of the areas where it operates. The ratings were far ahead of the next-closest insurance company, clearly showing that it has a leading edge at providing great customer service. In a separate study, J.D. Power also ranked Kaiser as having the best customer satisfaction for Medicare Advantage customers.

On the individual and Medicare marketplaces, plans are very highly rated. Individual and family plans receive between 4 and 5 stars overall. In particular, Kaiser stands out in its ratings for diabetes care, pregnancy care, preventative services and plan administration, which includes customer service. Medicare Part D plans have between 4.5 and 5 stars, far above the other major insurance providers, and Medicare Part C plans have 4 to 5 stars, on average.

Kaiser health plans received strong overall ratings from the National Committee for Quality Assurance (NCQA). The one exception is the PPO plan in Washington state, called Kaiser Options, which received a moderate performance rating of 3.5. All others received a high performance rating of 4.0 or more, with plans in Maryland, Virginia and the District of Columbia receiving the highest possible rating of 5 stars.

Similarly, Kaiser also has a good rating from the National Association of Insurance Commissioners (NAIC), with the national company scoring 0.77 on the complaint index, which is 23% fewer complaints than average. The most common complaint is claim handling delays. While delays are not ideal, it's a much better problem than Anthem's high rate of claim denials.

Frequently asked questions

Is Kaiser a good insurance company?

Kaiser Permanente is one of the best-rated health insurance companies, earning top scores for its customer service, 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 $351 in Maryland to $464 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 2021 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 National Association of Insurance Commissioners (NAIC).

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.

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