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We offer Medicare Advantage (HMO) health plans in different areas of Washington state.
Medicare Advantage HMO Service Area (PDF)

Prescription drug transition policy

Temporary medication supplies

As a new or continuing member in our Medicare health plan, you may be taking drugs that are not on our formulary. Or, you may be taking a drug that is on our formulary but your ability to get it is limited. For example, you may need a prior authorization from us before you can fill your prescription. You should talk to your doctor to decide if you should switch to an appropriate drug that we cover or request a formulary exception so that we will cover the drug you take. While you talk to your doctor to determine the right course of action for you, we may cover your drug in certain cases during the first 108 days you are a member of our health plan.

For each of your drugs that is not on our formulary or if your ability to get your drugs is limited, we will cover a temporary 30-day supply (unless you have a prescription written for fewer days) when you go to a network pharmacy. After your first 30-day supply, we will not pay for these drugs, even if you have been a member of the plan less than 108 days.

If you are a resident of a long-term care facility, we will allow you to refill your prescription until we have provided you with at least 91 and up to 98-day transition supply, consistent with dispensing increment (unless you have a prescription written for fewer days). We will cover more than one refill of these drugs for the first 90 days you are a member of our health plan. If you need a drug that is not on our formulary or if your ability to get your drugs is limited, but you are past the first 90 days of membership in our health plan, we will cover a 31-day emergency supply of that drug (unless you have a prescription for fewer days) while you pursue a formulary exception.

Kaiser Permanente ensures that members in transition have access to all Medicare Part D-covered medications without an interruption in therapy.

If you have questions about the prescription drug transition policy, please contact Member Services.

Prescription drug transition policy (PDF)

Questions? Call us

Prospective members
8 a.m. to 8 p.m., 7 days a week
1-800-446-8882
TTY 711

Current members
MEMBER SERVICES
8 a.m. to 8 p.m., 7 days a week
1-888-901-4600
TTY 711

Medicare Star Quality Ratings

Our Medicare Advantage health plan was rated 4.5 out of 5 Stars in Washington for 2021. The Medicare Star Rating is based on quality, service, and member satisfaction. Our high rating means you can have peace of mind knowing that you're getting high-quality care and coverage — all in a single plan at a great value.1

NCQA Quality Rating

Kaiser Permanente Washington Medicare Advantage (HMO) plan was rated 4.5 out of 5 in the National Committee for Quality Assurance (NCQA) Medicare Health Insurance Plan Ratings 2019-2020.2