Kaiser Advantage Plan Options

Kaiser Advantage Plan Options: Plan Details

Kaiser Permanente Senior Advantage Plans

Our Medicare Senior Advantage plans work much like an HMO plan, where members have set copays for services. 

  • Medical, mental health, prescription, and vision coverage are all through Kaiser Permanente.
  • Enrollment into this plan requires enrollment into Medicare Parts A and B.
  • This plan is a local plan. Retired employees must live in the Fresno coverage area to enroll.

 

Provider Information

Provider Information:

This plan uses a provider network. You may only access services at a Kaiser facility, unless otherwise approved by Kaiser.

  • Physicians:
    • You will have an assigned primary care physician.
  • Specialists:
    • You may need a referral to see certain specialists.
  • Behavioral Health Providers:
    • You may self-refer to a behavioral health provider, as long as the provider is within the Kaiser network (contact Kaiser for details).

Kaiser Permanente Nurse Line

24/7 Care By Phone (Northern California)

(866) 454 - 8855 (TTY 711)

Kaiser Permanente Online

Kaiser Permanente members also have access to Kaiser's website and smartphone application. Both allow users to keep in contact with their doctors with ease, and the smartphone application allows for both phone and video conference appointments so members can see their doctor without the hassle of going to the doctor's office.  

 Smartphone Application: My Doctor Online App

Website: www.kp.org

 

KSPA - High Option

High Option

This plan is called the "High Option," because it has higher monthly premiums, but lower copays for services. Enrollment into this plan requires enrollment into Medicare Parts A and B. This plan has prescription drug coverage (Part D) included. Therefore, if you enroll in this plan do not sign up for another Part D program as this will cancel your coverage through the County of Fresno.

Deductibles & Copays (High Option):

  • There is no deductible for this plan.
  • Your office visit copay is $15.
  • Deductibles and copays are waived if accessing preventive care services.

To learn more, contact a Senior Advantage specialist toll free at (800) 443-0815 (TTY (800) 777-1370). Specialists are available to assist you seven days a week from 8:00am to 8:00pm. 

Detailed Benefits & Coverage Information (High Option):

 

KSPA - Low Option

Low Option

This plan is called the "Low Option," because it has lower monthly premiums, but higher copays for services. Enrollment into this plan requires enrollment into Medicare Parts A and B. This plan has prescription drug coverage (Part D) included. Therefore, if you enroll in this plan do not sign up for another Part D program as this will cancel your coverage through the County of Fresno.

Deductibles & Copays (Low Option):

  • There is no deductible for this plan.
  • Your office visit copay is $25.
  • Deductibles and copays are waived if accessing preventive care services.

To learn more, contact a Senior Advantage specialist toll free at (800) 443-0815 (TTY (800) 777-1370). Specialists are available to assist you seven days a week from 8:00am to 8:00pm. 

Detailed Benefits & Coverage Information (Low Option):

 

 

Health Plan Contact Information

Kaiser Permanente Member Services
Phone: (800) 443 - 0815

Senior Advantage Specialist
Toll Free Phone: (800) 443 - 0815
Toll Free Phone TTY: (800) 777-1370

KSPA High Option Group Number
604334 - 0000

KPSA Low Option Group Number
604334 - 0001

 

Human Resources - Employee Benefits Division

Phone:(559) 600 - 1810
Email:HRBenefits@fresnocountyca.gov
Fax:(559) 455 - 4787

Address*:2220 Tulare St., Suite 1400, Fresno, CA 93721

*Please note that Employee Benefits is not responsible for any lost or stolen mail,
nor mail received after the deadline. All paperwork and supporting documentation
must be received by the Employee Benefits office prior to any deadlines.
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