Kaiser Permanente medical plan – California residents only

Kaiser Permanente is a Health Maintenance Organization (HMO) medical plan available in California only. If you choose the Kaiser Permanente Plan, your primary care physician (PCP) coordinates your care, typically at one location, within the Kaiser network. Prescription drug coverage is included.

At Kaiser Permanente, physician-led teams work together to make sure the care you get is tailored to your needs. Your care team is connected to your electronic health record, which makes it easy to share information, see your health history, and deliver high-quality, personalized care — when and where you need it. Your care team – no matter who you see in the network – has access to all your important records.

Manage your care online

See how easy it is to stay on top of your care. When you register at kp.org, you get the most out of your Kaiser Permanente membership — and can manage your health anytime, anywhere. When you register for an online account, you can access many time-saving tools and tips for healthy living, including:

• View most lap test results

• Refill most prescriptions

• Choose your doctor based on what’s important to you, and change anytime

• Email your Kaiser Permanente doctor’s office with non-urgent questions

• Schedule and cancel routine appointments

• Print vaccination records for school, sports, and camp

• Manage a family member’s health

Register for an online account at kp.org or on the Kaiser Permanente mobile app.

• Follow the sign-on instructions. You’ll need your health/medical record number, which you can find on your Kaiser Permanente ID card.

Eligibility: All Kaiser Permanente plan enrollees.

Get started: Register at kp.org/register or download the mobile app

• Kaiser Permanente traditional HMO plan details

  	Self-only coverage (A family of one member)	Family coverage (Each member in a family of two or more members)	Family coverage (Entire family of two or more members)
  Plan out-of-pocket maximum	$1,500	$1,500	$3,000
  Deductible	None	None	None
  Drug deductible	None	None	None

  	In-network only
  Company contributions to HSA	Not available
  Physician office visit	Most primary care visits and most non-physician specialist visits: $20 copay Most physician specialist visits: $20 copay
  Routine physical maintenance exams, including well-woman visits	No charge
  Well-child preventive exams (through age 23 months)	No charge
  Scheduled prenatal care exams	No charge
  Routine eye exams with a plan optometrist	No charge
  Urgent care consultations, evaluations, and treatment	$20 copay
  Most physical, occupational, and speech therapy	$20 copay
  Telehealth visits (primary care and physician specialist)	No charge
  ER visit	$150 copay
  Ambulance services	$50 copay
  Inpatient hospital admission	$500 copay per admission
  Outpatient surgery	$100 copay per procedure
  Standard Imaging (Lab and X-ray)	$10 copay
  Advanced Radiological Imaging (e.g., MRI, CT, PET scans)	$50 copay
  Infertility Treatment	Certain services covered; 50% coinsurance
  Mental Health/Substance Abuse Services	Inpatient: $500 copay Outpatient: $20 copay
  Home health care (up to 100 visits)	No charge
  Eyeglasses or contact lenses every 24 months	$350 allowance
  Hearing aids every 36 months	$1,000 allowance

  Please click here to view a chart of your biweekly paycheck cost.

  You can also review these FAQs on salary bands.

  Key terminology

  Deductible

  The amount you need to pay out of pocket before your plan starts paying benefits.

  Coinsurance

  The amount you pay for care after you meet your deductible. Coinsurance is generally a percentage of the total cost of care for specific services.

  Out-of-pocket maximum

  The most you’ll pay in a given year for all covered health care expenses. After you or any other eligible family member pays this amount, your plan pays 100% for the rest of the calendar year. Or, after the family out-of-pocket maximum has been met, the Plan pays 100% for each eligible family member’s expenses.