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Kaiser Permanente Senior Advantage Liberty (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Kaiser Permanente Senior Advantage Liberty (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 Liberty (HMO) in 2025, please refer to our full plan details page.
Kaiser Permanente Senior Advantage Liberty (HMO) is a HMO plan offered by Kaiser Foundation Health Plan, Inc. available for enrollment in 2025 to people living in Atlanta Full Metro Area. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that Kaiser Permanente Senior Advantage Liberty (HMO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Kaiser Permanente Senior Advantage Liberty (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 Liberty (HMO), 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.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
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 Liberty (HMO)
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Drug Coverage
Prescription drugs are not covered by Kaiser Permanente Senior Advantage Liberty (HMO).
Additional Benefits
The Kaiser Permanente Senior Advantage Liberty (HMO) plan offers a range of benefits with varying costs. You can expect no copay for primary care, preventive services, home health services, and outpatient blood services. However, many services have copays, including inpatient hospital stays, outpatient services, emergency services, specialist visits, and hearing exams. This plan also provides coverage for dental, vision, and hearing services, with copays and coinsurance depending on the specific service. Additionally, the plan includes coverage for ambulance services, with a copay, and transportation to health-related locations at no cost.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you will pay a $295 copay for days 1-6, and no copay for days 7-90; for Inpatient Hospital Psychiatric, you will pay a $295 copay for days 1-5, and no copay for days 6-90; additional days for Inpatient Hospital-Acute have no copay.
Outpatient Services See details
Outpatient services include coverage for all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital and Observation Services have a copay between $0 and $275, ASC services have a $275 copay, and outpatient blood services have no copay. Outpatient substance abuse services have a copay of $40 for individual sessions and $20 for group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered under the Kaiser Permanente Senior Advantage Liberty (HMO) plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services with a $225 copay. Transportation Services to a plan-approved health-related location are covered with no copay, up to 18 one-way trips per year, while transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Kaiser Permanente Senior Advantage Liberty (HMO) plan. Emergency Services and Worldwide Emergency Coverage have a $125 copay, Urgently Needed Services has a $40 copay, and Worldwide Emergency Transportation has a $225 copay; there is no coinsurance for any of these services. Worldwide Urgent Coverage has a $40 copay; there is no coinsurance for this service.
Primary Care See details
The Kaiser Permanente Senior Advantage Liberty (HMO) plan covers primary care physician services with no copay and chiropractic services with 20% coinsurance. Occupational therapy services have a $40 copay, while physician specialist services have a copay between $0 and $40. Mental health services, psychiatric services, and opioid treatment services all have a minimum copay of $20 and a maximum copay of $40. Physical therapy and speech-language pathology services have a $40 copay, and additional telehealth benefits have no copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and additional preventive services, including Health Education, with no copay. Other services such as In-Home Safety Assessment, Medical Nutrition Therapy, and others are not covered.
Hearing Services See details
Hearing exams are covered with a $40 copay, and routine hearing exams have no copay. Prescription hearing aids and OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams with a copay of $0-$40 and eyewear with 20% coinsurance. Routine eye exams have no copay, and contact lenses have a coinsurance of 20%. Eyeglass lenses and frames are covered. Upgrades are not covered.
Dental Services See details
Dental Services include Medicare Dental Services with a $40 copay, Oral Exams with no copay and 75% coinsurance, Dental X-Rays with no copay and 75% coinsurance, Other Diagnostic Dental Services with no copay and 75% coinsurance, Prophylaxis (Cleaning) with no copay and 75% coinsurance, Fluoride Treatment with no copay and 75% coinsurance, Other Preventive Dental Services with no copay and 75% coinsurance, Restorative Services with a copay from $28 to $580 and 75% coinsurance, Adjunctive General Services with no copay and 75% coinsurance, Periodontics with a copay from $0 to $400 and 75% coinsurance, Prosthodontics, removable with a copay from $420 to $480, and Oral and Maxillofacial Surgery with a $22 copay and 75% coinsurance; Endodontics, Implant Services, Prosthodontics, fixed, and Orthodontics are offered as optional, supplemental benefits. Maxillofacial Prosthetics is not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, are covered. For Medicare Part B Insulin Drugs, the copay is between $0 and $35. For Medicare Part B Chemotherapy/Radiation Drugs, the copay is between $0 and $47, and the coinsurance is between 0% and 20%. For Other Medicare Part B Drugs, the copay is between $0 and $47, and the coinsurance is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Kaiser Permanente Senior Advantage Liberty (HMO) plan. You will pay 20% coinsurance.
Medical Equipment See details
Medical equipment is covered by the Kaiser Permanente Senior Advantage Liberty (HMO) plan, including durable medical equipment with a 0-20% coinsurance and Prosthetic Devices with a 20% coinsurance. Diabetic supplies have no copay, while diabetic therapeutic shoes/inserts have a 20% coinsurance, and durable medical equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for Diagnostic Procedures/Tests with a copay between $0 and $35, Lab Services with no copay, Diagnostic Radiological Services with a copay up to $245, Therapeutic Radiological Services with a $40 copay, and Outpatient X-Ray Services with no copay. All services require prior authorization and a doctor referral.
Home Health Services See details
Home Health Services are covered by the Kaiser Permanente Senior Advantage Liberty (HMO) plan with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Kaiser Permanente Senior Advantage Liberty (HMO) plan. Prior authorization and a doctor referral are required for these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Kaiser Permanente Senior Advantage Liberty (HMO) plan. There is no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
The "Other Services" benefit covers Over-the-Counter (OTC) items with a maximum benefit of $125 every three months. Other services like Acupuncture, Meal Benefit, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered. Other 1 has a copay of $295 - $1475, and Other 2 has a coinsurance of 0% - 20%.
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