Kaiser Permanente Sr Advantage Basic Sac., Sonoma (HMO)
Kaiser Permanente · HMO · 2027 coverage
The big numbers
The plan premium is on top of your Part B premium.
- Monthly premium
- $29
- Higher than most plans here
- Most you pay in a year for covered care in network
- $6,000
- Highest of 4 plans here
- Drug deductible
- $0
- Medicare star rating
- No rating yet
In plain English
Compared with the 3 other plans in Sutter County that the same person could join.
What stands out
- No drug deductible
Watch out for
- $29 monthly premium, higher than most plans here
- Up to $6,000 a year for covered care, highest of 4 plans here
- $2,250 for a 5-day hospital stay, highest of 4 plans here
- $30 for specialist visits, highest of 4 plans here
What a year could cost
Premiums plus the plan’s copays for three example years. Medicines are not included.
- A light year$348$348 in premiums + $0 for careHigher than most plans here2 checkups and 2 lab tests.
- A busier year$498$348 in premiums + $150 for careHigher than most plans here4 checkups, 4 specialist visits, 4 lab tests, 1 X-ray and 1 urgent care visit.
- A hard year$4,038$348 in premiums + $3,690 for careHigher than most plans here6 checkups, 12 specialist visits, 6 lab tests, 2 scans, an ambulance ride, an ER visit and a 5-day hospital stay.Uses the highest listed cost for: MRI, CT and other scans.
The visit counts are examples we chose to show how costs add up, not a prediction. Your costs depend on the care you get.
What you pay for care
Your cost each time, at doctors and hospitals in the plan’s network.
- Primary care visit$0
- Specialist visit$30Highest of 4 plans hereReferral needed
- Urgent care$0
- Emergency room$130Higher than most plans hereNot charged if you stay in the hospital within 24 hours
- Hospital stay$450 a day for days 1 to 5, then $0 for days 6 to 90Highest of 4 plans hereReferral neededPlan approval may be needed
- Lab tests$0Referral needed
More care: surgery, X-rays, scans, ambulance, nursing home
- Outpatient surgery center$450Highest of 4 plans here
- Outpatient hospital care$0 to $450Depends on the service
- X-rays$30Highest of 4 plans hereReferral needed
- MRI, CT and other scans$30 to $300Depends on the serviceReferral needed
- Ground ambulance$350Tied for highest here
- Skilled nursing facility$0 for days 1 to 20, then $221 a day for days 21 to 100Referral needed
From the costs the plan filed with Medicare for 2027. A range like “$0 to $100” means the cost depends on the service or the place. “Lower than most” compares this plan with the 3 other plans in Sutter County that the same person could join. Ask the plan for its 2027 Evidence of Coverage booklet for the full rules.
What medicines cost
| Drug tier | Network pharmacy |
|---|---|
| 1Preferred Generic | $0 |
| 2Generic | $5 |
| 3Preferred Brand | $47 |
| 4Non-Preferred Drug | $100 |
| 5Specialty Tier | 30% of the price |
| 6Vaccines | $0 |
For a 1-month supply. Covered insulin costs at most $35 for a month’s supply. Your medicine’s tier is on the plan’s drug list; check it below.
Check a medicine for 2027
Choose the exact medicine and strength to see if this plan covers it.
Extras
Help Original Medicare doesn’t give you.
- Dental IncludedCleanings and exams covered. Some bigger dental work included, more with an optional add-on you can buy.
- Vision IncludedYearly eye exam: $0.
- Hearing Not included
- Over-the-counter items IncludedCovered for things like vitamins, pain relief and bandages.
- Fitness IncludedIncludes gym or fitness classes, a home fitness kit and memory fitness.
- Rides to care IncludedRides to medical visits, no set number.
What changed from 2026
- Monthly premium2026$24 a month2027$29 a month
- Primary care visit2026$52027$0
- Urgent care2026$52027$0
- Hospital stay2026$375 a day for days 1 to 5, then $0 for days 6 to 902027$450 a day for days 1 to 5, then $0 for days 6 to 90
- Outpatient surgery center2026$3252027$450
- Outpatient hospital care2026$0 to $3252027$0 to $450
- MRI, CT and other scans2026$30 to $2752027$30 to $300
- Skilled nursing facility2026$0 for days 1 to 20, then $150 a day for days 21 to 1002027$0 for days 1 to 20, then $221 a day for days 21 to 100
- Vision2026Yearly eye exam: $52027Yearly eye exam: $0
- Fitness2026Fitness benefit included2027Includes gym or fitness classes, a home fitness kit and memory fitness
- Rides to care2026Not covered2027Rides to medical visits, no set number
Your doctor’s participation
Individual provider participation for this plan year has not been confirmed. Call the doctor’s office. A missing listing does not mean out of network.