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Kaiser Permanente Senior Advantage Bronze DM (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Kaiser Permanente Senior Advantage Bronze DM (HMO-POS). 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 Bronze DM (HMO-POS) in 2026, please refer to our full plan details page.
Kaiser Permanente Senior Advantage Bronze DM (HMO-POS) is a HMO-POS plan offered by Kaiser Foundation Health Plan, Inc. available for enrollment in 2025 to people living in Denver Metro Area. 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 Bronze DM (HMO-POS) 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 Bronze DM (HMO-POS).
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 Bronze DM (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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 $5900.00 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:
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Drug Coverage
The Kaiser Permanente Senior Advantage Bronze DM (HMO-POS) plan features a $0 prescription drug deductible, meaning your coverage begins immediately. For Tier 1 preferred generic drugs, you will pay no copay at preferred pharmacies or through standard mail order. Additionally, Tier 6 vaccines feature no copay for a one-month supply at both standard and preferred pharmacies. When filling Tier 2 generic prescriptions, you pay no copay via standard mail order, or copays starting at $7 at preferred pharmacies. Tier 3 preferred brand drugs and Tier 4 non-preferred drugs carry copays starting at $45 and $90 respectively at preferred pharmacies, while Tier 5 specialty medications require a 33% coinsurance.
Additional Benefits
The Kaiser Permanente Senior Advantage Bronze DM (HMO-POS) plan offers robust core medical coverage with predictable costs, including no copay and no coinsurance for primary care visits, telehealth, and routine preventive services. Specialist consultations require a $35 copay, while inpatient hospital stays carry a $350 daily copay for the first six days followed by no copay for days seven through ninety. Emergency care is available with a $130 copay, and outpatient hospital visits require a $350 copay, with both services featuring no coinsurance. Beyond standard medical care, this plan provides valuable supplemental benefits like routine vision and hearing exams with no copay, alongside allowances for eyewear and hearing aids. Preventive dental care is covered with no copay up to a $2,000 annual limit, while comprehensive dental services require a 50% coinsurance with no copay. Additionally, members can access up to 18 free one-way transportation trips to approved locations and receive a $40 quarterly allowance for over-the-counter items with no copay.
Inpatient Hospital See details
Kaiser Permanente Senior Advantage Bronze DM (HMO-POS) partially covers inpatient hospital services with no coinsurance and a copay of $350 per day for days 1 through 6, and no copay for days 7 through 90. Unlimited additional acute days are covered with no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Kaiser Permanente Senior Advantage Bronze DM (HMO-POS) covers outpatient services with no coinsurance, including a $350 copay for outpatient hospital visits and a $185 copay for ambulatory surgical center services. Outpatient substance abuse sessions require a $10 copay for individual visits or a $5 copay for group visits with no coinsurance, while observation and outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Kaiser Permanente Senior Advantage Bronze DM (HMO-POS) covers partial hospitalization with a $45.00 copay and no coinsurance. Prior authorization and a referral are required to receive these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered under the Kaiser Permanente Senior Advantage Bronze DM (HMO-POS) plan, featuring a $350 copay and no coinsurance per ground or air ambulance trip. Transportation is partially covered with no copay or coinsurance for up to 18 one-way trips per year to plan-approved locations, though transport to any health-related location is not covered.
Emergency Services See details
Kaiser Permanente Senior Advantage Bronze DM (HMO-POS) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted, and urgently needed services with a $40 copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no coinsurance, carrying copays of $130, $40, and $350 respectively.
Primary Care See details
Kaiser Permanente Senior Advantage Bronze DM (HMO-POS) covers primary care and telehealth services with no copay and no coinsurance, while specialist visits require a $35 copay and no coinsurance. Physical and occupational therapy are covered with a $25 copay, mental health services range from a $5 to $10 copay, and routine podiatry has no copay, all with no coinsurance, while chiropractic services are not covered.
Preventive Services See details
Kaiser Permanente Senior Advantage Bronze DM (HMO-POS) covers annual physicals, health education, fitness benefits, and most screenings with no copay and no coinsurance, while kidney disease education has a $0 to $35 copay and no coinsurance. Additional preventive services are only partially covered, excluding benefits such as in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management, and counseling.
Hearing Services See details
Hearing services are covered by Kaiser Permanente Senior Advantage Bronze DM (HMO-POS), offering routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are covered up to $550 per ear every two years with no copay and no coinsurance, but only some services are covered as inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Kaiser Permanente Senior Advantage Bronze DM (HMO-POS) covers routine eye exams and eyewear, including contacts and eyeglasses, with no copay, no coinsurance, and a $500 annual limit. This benefit is partially covered, as other eye exam services and eyewear upgrades are not covered.
Dental Services See details
Kaiser Permanente Senior Advantage Bronze DM (HMO-POS) provides partially covered dental services, featuring Medicare-covered dental for a $35 copay and no coinsurance, alongside preventive care with no copay and no coinsurance up to a $2,000 annual limit. Comprehensive dental services like endodontics and periodontics are covered with no copay and 50% coinsurance, while orthodontics and other preventive dental services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Kaiser Permanente Senior Advantage Bronze DM (HMO-POS) with prior authorization, including insulin with a $7.00 to $35.00 copay and no coinsurance. Covered Medicare Part B chemotherapy, radiation, and other drugs require a copay of $7.00 to $47.00 and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Kaiser Permanente Senior Advantage Bronze DM (HMO-POS) covers Dialysis Services with no copay and a 20% coinsurance, though a referral is required to receive these services.
Medical Equipment See details
Kaiser Permanente Senior Advantage Bronze DM (HMO-POS) covers medical equipment with prior authorization, offering durable medical equipment with no copay and 0% to 20% coinsurance. Prosthetics, medical supplies, and diabetic therapeutic shoes or inserts are covered with no copay and a 20% coinsurance, while diabetic supplies feature no copay.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Kaiser Permanente Senior Advantage Bronze DM (HMO-POS) plan with no coinsurance, though prior authorization and referrals are required. Members pay no copay for lab services, outpatient X-rays, and diagnostic procedures, while diagnostic radiological services require a minimum $80 copay and therapeutic radiological services require a minimum $35 copay.
Home Health Services See details
Home health services are covered under the Kaiser Permanente Senior Advantage Bronze DM (HMO-POS) plan with no copay and no coinsurance. Prior authorization and a referral are required to receive these services.
Cardiac Rehabilitation Services See details
Kaiser Permanente Senior Advantage Bronze DM (HMO-POS) covers some Cardiac Rehabilitation Services with no coinsurance and a required referral, although cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered. For these excluded services, potential copayments range from $0 to $35 depending on the specific rehabilitation type.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is partially covered by Kaiser Permanente Senior Advantage Bronze DM (HMO-POS) with no coinsurance, featuring no copay for days 1 to 20 and 51 to 100, and a $203 daily copay for days 21 to 50. Prior authorization and referrals are required, and additional days beyond the standard Medicare-covered 100 days are not covered.
Other Services See details
Other Services are partially covered by Kaiser Permanente Senior Advantage Bronze DM (HMO-POS), offering over-the-counter items with no copay and no coinsurance up to $40 every three months, and select non-Medicare DME and medical supplies with no copay and 0% to 20% coinsurance. Acupuncture and meal benefits are not covered under this plan.
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