kaiser Permanente vs United Healthcare: Which Company is Best in 2021?

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Kaiser Permanente is a U.S-based integrated managed care conglomerate founded in 1945. Its headquarter is situated in Oakland, California. Founded by Henry J. Kaiser and Sidney Garfield, Kaiser Permanente consists of three separate but interdependent groups. These are the Kaiser Foundation Health Plan, Inc. (KFHP), Kaiser Foundation Hospitals, and Permanente Medical Groups. It is the largest managed care organization in the United States.

UnitedHealth Group Incorporated or United Healthcare is an American for-profit health care company. Founded in 1977 by Richard T. Burke, the company is headquartered in Minnetonka, Minnesota. It is the largest health care company in the world with a revenue of 242.2 billion dollars in 2019. As of 2020, the company has been ranked 7th on the Fortune 500 list.

Kaiser Permanente vs United Healthcare

Both Kaiser Insurance and United Healthcare offer a wide range of benefits to its members. Here is a brief comparison between these two companies to help you decide which company meets your needs:

Network coverage

Kaiser Permanente offers health care insurance to its consumers in 9 states of the United States. These states include California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, Washington, and Washington D.C. On the other hand, United Healthcare offers services throughout the nation. As a result, the number of health care professionals and hospital facilities is more than Kaiser.

Insurance plan type

Both Kaiser Permanente and United Healthcare offer HMO (Home Maintenance Organisation) to its members. HMOs generally cost lower than other plans and are predictable. With the HMO plan, first, you have to visit your Primary Care Physician (PCP) and consult with them. If they fail to treat, they will refer you to someone else within the network. HMO doesn’t cover your insurance outside the network.

Besides HMO, United Healthcare also offers PPO (Preferred Provider Organisation). PPO members are not restricted to only receiving care within the network. They can make direct appointments with the doctors outside the network, without any referral. In this case, patients have to pay the doctors first and afterward file a claim for the reimbursement. PPO plans are flexible but come with a higher premium cost.

Medicare Advantage Plans

Medicare Advantage or Medicare Part C plans include the Original Medicare (Parts A & B) and other additional benefits.

Kaiser Permanente United Healthcare
Home Maintenance Organisation (HMO) Exclusive Provider Organisation (EPO)

Preferred Provider Organisation (PPO)

Health Maintenance Organisation (HMO)

Private Fee-for-Service (PFFO) / Point-of-service (POS)

 

In United Healthcare, Medicare Advantage plans sometimes come with Prescription Drug Coverage (PDC Part D). Meanwhile, Kaiser’s Medicare Advantage plan always includes PDC Part D. So Kaiser Insurance offers hospital care, medical services, and prescription drug coverage, all under the same umbrella. Kaiser calls their Medicare Advantage plans as Senior Advantage plans.

Insurance plans for Small business employers

Both Kaiser Permanente and United Healthcare offer the following insurance plans for small business employers –

  • Bronze Plan
  • Silver Plan
  • Gold Plan
  • Platinum Plan

The following tables will help you understand how much you can save with Kaiser Insurance and United Healthcare:

Savings with Kaiser Permanente:

Services Offered KP Bronze 60 HSA HMO

(Your Cost)

KP Silver 70 HMO 1500/40

(Your Cost)

KP Gold 80 HMO Co-insurance

(Your Cost)

KP Platinum 90 HMO

(Your Cost)

Preventive Care None None None None
Primary Care 40% after deductible $40 $35 $20
Inpatient Hospital Care 40% after deductible 30% after deductible 20% $290 a day up to 5 days
Outpatient Surgery 40% after deductible 30% after deductible 20% $290
Prenatal and Postnatal None None None None
Delivery and Inpatient Well-Baby Care (Maternity) 40% after deductible 30% after deductible 20% $290 a day up to 5 days
Lab Tests 40% after deductible $35 after deductible $35 $20
X-rays 40% after deductible 40% after deductible $50 $40
Urgent Care 40% after deductible $40 $35 $20
Ambulance Services 40% after deductible $250 after deductible $250 $150
Generic Drugs 40% after deductible $20 $15 $5
Specialty Drugs 40% after deductible 30% after $250 brand deductible 20% up to $250 per prescription 10% up to $250 per prescription
Emergency Department Visit 40% after deductible $250 after deductible $250 $150
Mental Health Visit 40% after deductible $40 $35 $20
MRI, CT, PET 40% after deductible $250 after deductible 20% $150

 

Savings with United Healthcare:

Bronze Plan 60% of the actual covered benefits
Silver Plan 70% of the actual covered benefits
Gold Plan 80% of the actual covered benefits
Platinum Plan 90% of the actual covered benefits

 

Industrial Ratings

Both Kaiser Permanente and United Healthcare are one of the topmost health insurance companies in the world. The Standard and Poor’s gave a financial strength rating of “A+” to Kaiser Permanente. Whereas United Healthcare scored a financial strength rating of “AA-”. This means both the companies do not have any problem with the payments of the consumers. But United Healthcare is a step ahead of Kaiser Insurance with “AA”.

In the end, we can conclude that both Kaiser Insurance and United Healthcare offer a wide range of benefits to their members. Now it is your choice to decide which company you will opt for based on your needs and financial strength.

Frequently Asked Questions

Does Kaiser accept United Healthcare?

If you are a member of United Healthcare, you will not be able to use Kaiser Permanente’s facilities. In the same way, if you have Kaiser, you cannot use doctors or hospitals that are registered under United Healthcare. So it is your decision about which provider you want to use. If you often see doctors that are outside Kaiser providers, it is better to opt for United Healthcare.

Do you have to be an AARP member to get United health care?

United Healthcare pays royalty fees to AARP so that they can use its properties and services. AARP uses these fees for general purposes and does not provide insurance directly to the consumers. You get the insurance facilities through the insurance companies. Hence, you do not have to belong to AARP to enroll in United Healthcare.

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