Options Federal plus Medicare
Coordination of benefits with Original Medicare
In most cases, when you have coverage through Original Medicare, your claim will be coordinated automatically.
If you have Part A and Part B of Medicare, and Original Medicare is your primary payor, we will waive your out-of-pocket costs for Medicare-covered services as follows for the Standard Option:
- Deductible
- Inpatient hospital coinsurance
- Surgical and medical care coinsurance and copayments
We will not waive the following:
- Non-Medicare member’s cost-share
- If you have Part A only, we will not waive deductible, coinsurance, and copayments for Part B services (such as outpatient surgical or medical care)
- If you have Medicare Part B only, we will not waive deductible, coinsurance, and copayments for Part A services (such as home health, hospice, skilled nursing, or inpatient hospital care)
- Prescription drug copayments
- The High Deductible Health Plan (HDHP) deductible and coinsurance
To coordinate benefits, you must tell us about your Medicare coverage
You must tell us if you or a covered family member has Medicare coverage, and let us obtain information about services denied or paid under Medicare if we ask. You must also tell us about other coverage you or your family members may have, as this coverage may affect the primary/secondary status of your Kaiser Permanente Washington Options Federal coverage and your Medicare coverage. Members can download the Multiple Coverage Form to provide this information.
Want more information?
Call Member Services at 206-630-4636 or 1-888-901-4636 (TTY users 1-800-833-6388 or 711). Download the guide below to learn more about using Options Federal combined with Medicare.
View 2024 Medicare Plan Documents
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View2024 Kaiser Permanente Options Federal plan and Medicare
This page was last updated: October 1, 2023 at 3:00 pm PT
