A non-government entity
Kaiser Permanente Medicare Advantage Liberty (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Kaiser Permanente Medicare 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 Medicare Advantage Liberty (HMO) in 2026, please refer to our full plan details page.
Kaiser Permanente Medicare Advantage Liberty (HMO) is a HMO plan offered by Kaiser Foundation Health Plan, Inc. available for enrollment in 2025 to people living in DC, MD, VA. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Kaiser Permanente Medicare 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 Medicare 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 Medicare 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 $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
Prescription drugs are not covered by Kaiser Permanente Medicare Advantage Liberty (HMO).
Additional Benefits
The Kaiser Permanente Medicare Advantage Liberty (HMO) plan offers comprehensive medical coverage with predictable out-of-pocket costs and no coinsurance for many core services. Inpatient hospital stays require a daily copay of $295 for the first six days, followed by no copay for days seven through ninety. Primary care visits feature a low $15 copay, telehealth is available with no copay, and emergency services are covered with a $130 copay that is waived upon admission. This plan also includes key preventive, vision, dental, and hearing benefits to support your overall well-being. Preventive care, annual physicals, and home health services are covered with no copay and no coinsurance. Additionally, members benefit from routine dental care, vision exams, and hearing aid coverage with low or no copays, though some specialty services and medical equipment may require coinsurance up to 20 percent.
Inpatient Hospital See details
Kaiser Permanente Medicare Advantage Liberty (HMO) covers inpatient hospital services with no coinsurance, requiring a $295 daily copay for days 1 through 6 and no copay for days 7 through 90. Unlimited additional acute care days are covered at no copay, but additional psychiatric days, hospital upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Kaiser Permanente Medicare Advantage Liberty (HMO) covers outpatient services with no coinsurance, featuring copays ranging from no copay to $195 for outpatient hospital and observation services, and a $195 copay for ambulatory surgical center services. Outpatient substance abuse services require a $10 copay for group sessions and a $20 copay for individual sessions with no coinsurance, while outpatient blood services have no copay, no coinsurance, and no deductible.
Partial Hospitalization See details
Kaiser Permanente Medicare Advantage Liberty (HMO) covers partial hospitalization services with a $15.00 copay and no coinsurance. Prior authorization and a referral are required to receive coverage for this benefit.
Ambulance and Transportation Services See details
Kaiser Permanente Medicare Advantage Liberty (HMO) covers ground and air ambulance services with a $250 copay and no coinsurance, with prior authorization required. Transportation services to health-related locations are not covered.
Emergency Services See details
Emergency services under the Kaiser Permanente Medicare Advantage Liberty (HMO) are covered with a $130 copay and no coinsurance, which is waived if you are immediately admitted to the hospital. Urgently needed services require a $40 copay with no coinsurance, and worldwide emergency, urgent, and transportation services are covered with no coinsurance and copays of $130, $40, and $250 respectively.
Primary Care See details
Kaiser Permanente Medicare Advantage Liberty (HMO) covers primary care visits with a $15 copay and no coinsurance, specialist and therapy visits with a $40 copay and no coinsurance, and telehealth with no copay and no coinsurance. Mental health and psychiatric individual sessions require a $20 copay (group sessions are $10) with no coinsurance, while podiatry and chiropractic services are not covered.
Preventive Services See details
Kaiser Permanente Medicare Advantage Liberty (HMO) covers essential preventive services, including annual physical exams, fitness benefits, and diabetes self-management training, with no copay and no coinsurance. This benefit is partially covered, as sub-services like in-home safety assessments, personal emergency response systems, medical nutrition therapy, and weight management programs are not covered.
Hearing Services See details
Kaiser Permanente Medicare Advantage Liberty (HMO) hearing services are partially covered, offering Medicare-covered exams for a $40 copay and no coinsurance, while routine exams and OTC hearing aids are not covered. Hearing aid fittings and some prescription hearing aid services are covered with no copay and no coinsurance up to $1,000 per ear every three years, but inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Kaiser Permanente Medicare Advantage Liberty (HMO) provides partial coverage for vision services, featuring eye exams with a $0 to $40 copay and no coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay and a 20% coinsurance up to a $200 maximum benefit every two years, while upgrades are excluded.
Dental Services See details
Kaiser Permanente Medicare Advantage Liberty (HMO) partially covers dental services, excluding maxillofacial prosthetics, implant services, and orthodontics. Preventive care ranges from no copay to a $40 copay with no coinsurance, while comprehensive services require either no copay or a $40 copay and 50% coinsurance.
Home Infusion bundled Services See details
Kaiser Permanente Medicare Advantage Liberty (HMO) covers home infusion bundled services with prior authorization, offering Medicare Part B insulin with a $15 to $35 copay and no coinsurance. Covered chemotherapy, radiation, and other Part B drugs require a copay between $15 and $47, alongside coinsurance ranging from no coinsurance up to 20%.
Dialysis Services See details
Dialysis Services are covered by Kaiser Permanente Medicare Advantage Liberty (HMO) with no copay and a 20% coinsurance, although prior authorization and a referral are required.
Medical Equipment See details
Medical equipment is covered by Kaiser Permanente Medicare Advantage Liberty (HMO) with no copays, though prior authorization is required. Durable medical equipment carries a 0% to 20% coinsurance, diabetic supplies have no coinsurance, and prosthetic devices, medical supplies, and diabetic shoes require a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Kaiser Permanente Medicare Advantage Liberty (HMO) with no coinsurance, though prior authorization and referrals are required. Members pay no copay for diagnostic tests and lab services, a $10 copay for outpatient X-rays and diagnostic radiology, and a $40 copay for therapeutic radiology services.
Home Health Services See details
Home Health Services are covered by Kaiser Permanente Medicare Advantage Liberty (HMO) with no copay and no coinsurance. Both prior authorization and a referral are required to access this benefit.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by Kaiser Permanente Medicare Advantage Liberty (HMO) with no coinsurance, but only some services are covered while standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered. Covered services require a referral and prior authorization.
Skilled Nursing Facility (SNF) See details
Kaiser Permanente Medicare Advantage Liberty (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, though prior authorization and a referral are required. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, with no coverage provided for additional days.
Other Services See details
Kaiser Permanente Medicare Advantage Liberty (HMO) partially covers other services, excluding acupuncture and meal benefits. Covered services include over-the-counter items with no copay and no coinsurance up to $25 every three months, non-Medicare medical supplies and DME with no copay and 0% to 20% coinsurance, and non-Medicare ASC surgical procedures for a $195 copay and no coinsurance.
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