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.
Benefits
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
