Kaiser Permanente Senior Advantage Enhanced Solano (HMO)

Kaiser Permanente Senior Advantage Enhanced Solano (HMO) is a HMO plan offered by Kaiser Foundation Health Plan, Inc. available for enrollment in 2025 to people living in Solano County Plan - Enhanced. This plan received an overall rating of 4.5 out of 5 stars in 2026.

It's important to know that Kaiser Permanente Senior Advantage Enhanced Solano (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.

Key Plan Facts

Below are a few key facts and commonly-asked questions about Kaiser Permanente Senior Advantage Enhanced Solano (HMO).

Plan Costs:

The cost of a Medicare Advantage Plan is made up of four main parts.

• First, the monthly premium — the amount you pay every month.
• Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
• Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
• Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.

You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.

Common Services:

Drug Coverage

The Kaiser Permanente Senior Advantage Enhanced Solano (HMO) plan offers an Enhanced Alternative drug benefit with no prescription drug deductible. During the initial coverage phase, you will pay a $7 copay for preferred generic drugs, a $47 copay for standard generic drugs, and a $100 copay for preferred brand drugs. Non-preferred drugs require a 33% coinsurance, while specialty tier drugs feature no copay at standard pharmacies. Once your yearly out-of-pocket drug costs reach $2,100, you enter the catastrophic coverage phase and pay nothing for Medicare Part D covered drugs. Additionally, individuals who qualify for the full low-income subsidy will have their Part D premium reduced to $0. This structured plan helps you easily anticipate your annual prescription medication expenses.

Additional Benefits

The Kaiser Permanente Senior Advantage Enhanced Solano (HMO) plan offers comprehensive coverage with no copays for primary care visits, preventive services, routine eye exams, and home health care. For specialist visits, members pay a low $10 copay, while inpatient hospital stays require a $200 daily copay for the first five days and no copay for subsequent days. Emergency room visits carry a $150 copay that is waived upon admission, and urgent care services are available with no copay. Outpatient hospital services and diagnostic tests like labs and X-rays feature no copays, though diagnostic radiology services require a copay of up to $250. Members also benefit from no copays on diabetic supplies, acupuncture, and over-the-counter items, while other durable medical equipment and dialysis services require up to 20% coinsurance. For prescription needs, insulin is highly affordable with a copay ranging from $7 to $35 and no coinsurance.