Kaiser Senior Advantage Otc Catalog (2024)

FAQs

What is the quarterly OTC allowance for Kaiser? ›

You may order OTC items up to the $60 quarterly benefit limit. Each order must be at least $25. Your order may not exceed your quarterly benefit limit. Any unused portion of the quarterly benefit limit doesn't carry forward to the next quarter.

Products must be ordered from kp.org/otc/wa or by calling 1-833-238-6618 (TTY 711), Monday through Friday, 7 a.m. to 5 p.m. Cash, checks, credit cards, or money orders are not accepted. Limitations and restrictions may apply. Kaiser Permanente is an HMO plan with a Medicare contract.

As a Kaiser Permanente Senior Advantage member, you enjoy the ease of combining your Medicare coverage with Kaiser Permanente coverage in a single plan. Now, with Advantage Plus, you can get valuable comprehensive dental, fitness, hearing, and vision benefits added to your plan.

Understanding your costs

Kaiser Permanente Senior Advantage has no deductible and the out-of-pocket maximum is $1,500. Typical out-of-pocket costs: Office visits/Urgent care: $20.

You may check check the balance on your OTC benefit card by calling the number on the back of your card or signing in to your OTC plan provider's online member portal.

The OTC benefit — a common ingredient of Medicare Advantage plans⁴ — means funds to spend at pharmacies for OTC products. It might come as an OTC card you can use at participating retail stores. With this coverage, you receive a certain dollar amount per year, per quarter or per month.

Kaiser Permanente and Medline at Home have partnered to provide you with a quarterly over-the-counter health and wellness benefit covered under your 2024 Medicare health plan.

The final product must be approved by the FDA which requires presenting substantial evidence from clinical trials to prove safety and effectiveness for its proposed use and that its benefits outweigh the risks.

You can create a Walmart.com account and add your OTC Network card to your wallet or enter your OTC Network card as a payment method during check-out.

In addition to these services, Kaiser's Medicare Advantage HMO plans often include additional services, such as a SilverSneakers membership. This gives you membership to exercise programs at participating gym facilities, as well as several home fitness programs.

What is the difference between Kaiser Permanente Senior Advantage and Senior Advantage Summit? ›

Kaiser Permanente offers two Medicare Advantage plans: Senior Advantage with $10 co-payments for office visits. Senior Advantage Summit with $0 co-payments for office visits.

Senior Advantage combines your Kaiser Permanente coverage with your Medicare coverage into a single plan at no additional premium. Senior Advantage gives you all the benefits of Medicare, plus more. You may also save money with Senior Advantage because you pay only copayments for services.

People who have both Medicare and Medicaid/Medi-Cal coverage may be eligible for extra benefits through a Kaiser Permanente Medicare Medicaid Dual Special Needs Plan (D-SNP). A D-SNP lets you keep your Medicaid/Medi-Cal benefits and includes more benefits than Original Medicare.

out-of-pocket maximum

The most you'll pay for covered services each year. For a small number of services, you may need to keep paying copays or coinsurance after reaching your out-of-pocket maximum.

Reach age 55 with 15 or more years of Common Plan Qualifying Service, or. Reach age 65* with at least 10 years of Common Plan Qualifying Service, or. Have age plus years of Common Plan Service equal at least 75 (with 10 or more years of Qualifying service), or. Be a participant of the Early Separation Program (ESP)

Your OTC benefit helps you save money on a wide range of over-the-counter health and wellness products. You can use your benefit amount to purchase products such as pain relief, first aid, cold and allergy medicine, dental care items and more. Check your OTC catalog for the list of items covered by your benefit.

It gives you money to spend on eligible OTC products. This is typically a fixed allowance that comes every month or quarter. If you have the benefit, you can spend this money on a wide range of eligible items that help with health and wellness — items you might currently be paying for out of your own pocket.

Shop in stores*—Swipe your OTC card at participating physical retailers including CVS, Dollar General, Family Dollar, Rite Aid, Stop & Shop, Walgreens, and Walmart. For a complete list of participating retailers and locations, visit carepartnersct.com/order-OTC.

Generally, your Medicare drug plan only covers prescription drugs and won't pay for over-the-counter drugs, like aspirin or laxatives. Your Medicare drug plan will only cover prescription drugs that are on its formulary (drug list), unless it's covered by an exception.