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About Your Plans

Each of the four KelseyCare Advantage plans offers all of the benefits that the original Medicare plan offers, including doctor office visits, inpatient hospital care and outpatient services and surgery. And, as a KelseyCare Advantage member, you are still in the Medicare program.

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Benefits at a Glance

There are 4 KelseyCare Advantage plans to choose from. The Benefits At A Glance chart will assist you in finding a plan that’s right for you. Download a printable version of the Benefits at a Glance PDF PDF 2010.

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  Essential
(HMO)
Essential
+
Choice
(HMO POS)
Rx
(HMO)
Rx
+
Choice
(HMO POS)
Plan Summary

Essential (HMO)

Essential + Choice (HMO POS)

Rx (HMO)

Rx + Choice (HMO POS)

Monthly Plan Premium $0 $0 $0 $49
Part B Premium Contribution $30 - - -
Covers Medicare Parts A and B Yes Yes Yes Yes
Covers Medicare Part D     Yes Yes
Point of Service Benefits   Yes   Yes
Annual Deductible

$0

$0

$0 $0
Transportation All KCA plans offer 20 one-way trips to
plan-approved locations for $0 copay.
Summary of Benefits (PDF) PDF PDF 2010 PDF PDF 2010 PDF PDF 2010 PDF PDF 2010
Evidence of Coverage (PDF)

PDF PDF 2010 

PDF PDF 2010 

PDF PDF 2010   PDF PDF 2010
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H0332_WB10001_091809
Last Updated: 10/01/09