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Click ‘Get Form’ to open the kp org seniors enrollment form in the editor.
Begin by filling out your personal information in the required fields, including your Last Name, First Name, Middle Initial, Gender, and Permanent Residence Address. Ensure that you provide a valid street address without using a P.O. Box.
Next, complete the Medicare Health Insurance Card section by entering the details exactly as they appear on your card. If preferred, you can upload a photocopy of your Medicare verification letter.
Proceed to answer the additional required questions regarding your current or former membership with Kaiser Permanente and any existing health conditions such as end-stage renal disease (ESRD).
After completing all sections, review the 'Release of Information' and 'Conditions of Enrollment' sections carefully before signing and dating page 3.
Finally, keep a copy for your records and send the signed form to Kaiser Permanente using the provided postage-paid envelope.

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What is the difference between Kaiser Senior Advantage and Plus?

As a Kaiser Permanente Senior Advantage member, you enjoy the ease of combining your Medicare coverage with Kaiser Permanente coverage in a single plan. Now, with Advantage Plus, you can get valuable comprehensive dental, fitness, hearing, and vision benefits added to your plan.

Can I use Kaiser if I have Medicare?

You wont lose Part A and Part B coverage. When you become a member, Kaiser Permanente will provide your Medicare benefits to you. Keep in mind that to sign up for a Kaiser Permanente Medicare health plan, youll need to be enrolled in Medicare Part B.

What is Kaiser Senior Advantage 2 plan?

Senior Advantage 2 is designed to reimburse you for your Medicare Part B premium. This document explains how you enroll in and disenroll from Senior Advantage 2, as well as how we will reimburse you for the Medicare Part B premium you pay.

What does Kaiser Advantage Plus cover?

While Original Medicare (Parts A and B) doesnt typically cover dental implants, some Kaiser Permanente Medicare Advantage (Part C) plans may help pay for dental implants. Plan benefits and costs may vary, so its helpful to learn more about Kaiser Medicare Advantage plans and the types of coverage they may offer.

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