2021 Retiree Group Plan Comparison

There are two group plans available for eligible retired clergy members and their spouses.  Medicare Parts A & B are required in order to join these plans. Below is a side by side comparison of the plans.


Annual Deductible (Member/Family) None  None
Annual Copayment Maximum $1500  N/A
Available Service Area Within 30 miles of a Kaiser facility (CA,OR,WA,HI,CO,GA, DC, VA, MD) Anywhere that Medicare is Accepted
Preventative Health Services  
Annual Routine Physical Exam No Charge  No Charge
Well Woman Exam No Charge  No Charge
Labs & X-rays No Charge  No Charge
Physician Services  
Inpatient hospital & Skilled nursing facility No Charge  No Charge
Office Visits $15  $10
Labs & X-rays No Charge

 No Charge

Diagnostic Tests No Charge  No Charge
Mammogram and Pap test or other FDA-approved cervical screens No Charge  No Charge
Hospital Services  
Inpatient Services including semi-private room & board No Charge  No Charge
Outpatient services at an Ambulatory Surgery Center No Charge  No Charge
Outpatient surgery (Hospital) $15/surgery No Charge
Short Term Rehabilitation Services (Physical, Occupational, Speech or Respiratory Therapy)  
Office $15/visit  $10/visit
Hospital No Charge

No Charge

Skilled Nursing Facility No Charge No Charge
Emergency Room  
ER Services $50 per visit (waived if admitted within 24 hours)  $50 per visit
Emergency Ambulance Services $50 per trip  
Prescription Drugs  
30-day Generic $10  $2
30-day Brand Name $25 $15
30-day Non-preferred Brand N/A  $35
90-day Mail Order Generic $20  $4
90-day Mail Order Brand Name $50  $30
90-day Mail Order Non-Preferred Brand N/A  $70
Psychiatric Care, Alcohol and Drug Abuse Services  
Inpatient - 30 day max No Charge No Charge
Outpatient Counseling Services $15/visit  $10/visit
Home Health Care  
Home health care agency including home visits by nurse, aide, therapist or hospice No Charge  No Charge