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Kaiser Permanente Senior Advantage Basic Solano (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Kaiser Permanente Senior Advantage Basic Solano (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Kaiser Permanente Senior Advantage Basic Solano (HMO) in 2026, please refer to our full plan details page.
Kaiser Permanente Senior Advantage Basic 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 - Basic. 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 Basic 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 Basic 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.
For Kaiser Permanente Senior Advantage Basic Solano (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $16.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6000.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for Kaiser Permanente Senior Advantage Basic Solano (HMO)
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Drug Coverage
The Kaiser Permanente Senior Advantage Basic Solano (HMO) plan features an Enhanced Alternative drug benefit with no prescription drug deductible. During the initial coverage phase, you will pay no copay for Tier 1 preferred generic drugs and Tier 5 specialty drugs at standard pharmacies. For other medications, 30-day fills at standard pharmacies or through standard mail require a $35 copay for Tier 2 standard generics, a $95 copay for Tier 3 preferred brands, and a 33% coinsurance for Tier 4 non-preferred drugs. After your yearly out-of-pocket drug costs reach $2,100, you enter the catastrophic coverage phase and pay nothing for covered Part D prescription drugs. Additionally, beneficiaries who qualify for the low-income subsidy can reduce their Part D premium costs to $0. This plan offers a clear and structured pathway to manage your annual prescription expenses.
Additional Benefits
The Kaiser Permanente Senior Advantage Basic Solano (HMO) plan offers affordable access to essential medical care with low out-of-pocket costs. Primary care visits require a $5 copay, specialist visits are $25, and there is no copay for preventive annual exams. For hospital stays, inpatient care requires a $300 copay for days 1 to 5 followed by no copay for additional days, while emergency room visits carry a $130 copay that is waived if you are admitted. Diagnostic lab tests, home health services, and partial hospitalization are all covered with no copay and no coinsurance. Skilled nursing facility care features no copay for the first 20 days, followed by a $100 daily copay up to day 100. While dental, vision, and hearing services are partially covered, routine hearing exams, eyewear, and cardiac rehabilitation are not covered under this plan.
Inpatient Hospital See details
Kaiser Permanente Senior Advantage Basic Solano (HMO) partially covers inpatient hospital benefits, as non-Medicare-covered stays for both acute and psychiatric care are not covered. Covered acute and psychiatric stays require a $300 copay for days 1 to 5, no copay for days 6 to 999, and no coinsurance.
Outpatient Services See details
Outpatient services are covered by Kaiser Permanente Senior Advantage Basic Solano (HMO) with no coinsurance, featuring copays ranging from no copay to $275 for hospital services, up to $130 for observation services, and $275 for ambulatory surgical center visits. Outpatient substance abuse sessions require a $2 to $5 copay, while outpatient blood services are provided with no copay, no deductible, and no coinsurance.
Partial Hospitalization See details
Partial hospitalization benefits are covered by Kaiser Permanente Senior Advantage Basic Solano (HMO) with no copay and no coinsurance. A doctor referral is required to receive these covered services.
Ambulance and Transportation Services See details
Kaiser Permanente Senior Advantage Basic Solano (HMO) covers ground and air ambulance services with a $350 copay and no coinsurance, but other transportation services to health-related locations are not covered.
Emergency Services See details
Kaiser Permanente Senior Advantage Basic Solano (HMO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $5 copay and no coinsurance, while worldwide emergency care, urgent care, and emergency transportation are covered with copays of $130, $5, and $350, respectively, with no coinsurance.
Primary Care See details
Kaiser Permanente Senior Advantage Basic Solano (HMO) offers primary care visits for a $5 copay and specialist visits for a $25 copay, with no coinsurance. Telehealth and opioid treatment are available with no copay, while therapy and psychiatric services have copays ranging up to $25, but routine chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services are covered by Kaiser Permanente Senior Advantage Basic Solano (HMO) with no coinsurance and copays ranging from $0 to $5. While annual exams and screenings feature no copay, the plan is only partially covered, excluding in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, home-based palliative care, in-home support, caregiver support, tobacco cessation, enhanced disease management, telemonitoring, home safety modifications, and counseling.
Hearing Services See details
Kaiser Permanente Senior Advantage Basic Solano (HMO) partially covers hearing exams with a $25 copay and no coinsurance, though routine hearing exams are not covered. While some prescription hearing aid services are covered, prescription hearing aids (including all types, inner ear, outer ear, and over the ear) and over-the-counter hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Kaiser Permanente Senior Advantage Basic Solano (HMO), offering eye exams with no copay to a $25 copay ($5 for routine exams) and no coinsurance or deductible. Eyewear is not covered, including contact lenses, eyeglasses, frames, lenses, and upgrades.
Dental Services See details
Dental services are partially covered by Kaiser Permanente Senior Advantage Basic Solano (HMO), as maxillofacial prosthetics and orthodontics are not covered. Medicare-covered dental services require a $5.00 to $25.00 copay and no coinsurance, while other covered services have no copay and no coinsurance, though some of these are optional supplemental benefits that may require additional costs.
Home Infusion bundled Services See details
Kaiser Permanente Senior Advantage Basic Solano (HMO) covers home infusion bundled services, including chemotherapy, radiation, and other Medicare Part B drugs with copays ranging from no copay up to $47 and coinsurance from no coinsurance up to 20%. Additionally, Medicare Part B insulin drugs are covered with a copay of $12 to $35 and no coinsurance.
Dialysis Services See details
Kaiser Permanente Senior Advantage Basic Solano (HMO) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
Kaiser Permanente Senior Advantage Basic Solano (HMO) covers medical equipment, including durable medical equipment (DME), prosthetics, and diabetic equipment, with prior authorization required. Durable medical equipment and medical supplies carry a 0% to 20% coinsurance with no copay, prosthetic devices and diabetic shoes require a 20% coinsurance with no copay, and diabetic supplies are covered with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Kaiser Permanente Senior Advantage Basic Solano (HMO) covers diagnostic and radiological services with a doctor referral, featuring no copay or coinsurance for lab services, diagnostic tests, and therapeutic radiology. Outpatient X-rays require a $20 copay, and diagnostic radiological services range from a $20 to $275 copay, with no coinsurance required for any of these services.
Home Health Services See details
Kaiser Permanente Senior Advantage Basic Solano (HMO) covers Home Health Services with no copay and no coinsurance, although a doctor referral is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Kaiser Permanente Senior Advantage Basic Solano (HMO) plan, as all sub-services, including intensive cardiac, pulmonary, and SET for PAD rehabilitation, are not covered in practice.
Skilled Nursing Facility (SNF) See details
Kaiser Permanente Senior Advantage Basic Solano (HMO) covers Skilled Nursing Facility (SNF) services with a doctor referral and no required prior three-day hospital stay. There is no copay for days 1-20, a $100 daily copay for days 21-100, and no coinsurance, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Kaiser Permanente Senior Advantage Basic Solano (HMO) partially covers other services, excluding meal benefits and highly integrated SNP services. Covered benefits include acupuncture for a $5 copay and no coinsurance, over-the-counter items for no copay and no coinsurance, residential substance use treatment for a $100 copay and no coinsurance, and non-Medicare durable medical equipment for no copay and no coinsurance to 20% coinsurance.
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