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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 2010 Benefits at a Glance 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 Covered by plan Covered by plan Covered by plan Covered by plan
Covers Medicare Part D     Covered by plan Covered by plan
Point of Service Benefits   Covered by plan   Covered by plan
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) 2010 Essential Summary of Benefits PDF 2010 2010 Essential+Choice Summary of Benefits PDF 2010 2010 Rx Summary of Benefits PDF 2010 2010 Rx+Choice Summary of Benefits PDF 2010
Evidence of Coverage (PDF)

2010 Essential Evidence of Coverage PDF 2010 

2010 Essential+Choice Evidence of Coverage PDF 2010 

2010 Rx Evidence of Coverage PDF 2010   2010 Rx+Choice Evidence of Coverage PDF 2010
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Last Updated: 10/01/09