KAISER PERMANENTE

Available to California-based team members only

We offer a Kaiser HMO plan for team members in California. An HMO is a system of managed healthcare providing medical services within a specific geographic area. Kaiser Permanente has its own doctors, physician assistants, nurse practitioners, and operates its own hospitals and outpatient facilities. If you elect Kaiser, you do not have the option to seek treatment outside of Kaiser-Permanente-contracted facilities, except for emergencies.

There are copays for services such as office visits, specialist visits, and hospitalization, but no deductible. Generally, services are covered in full after the specified copays.

HMO Plan Highlights

  • You are required to select a Primary Care Physician (PCP) or Primary Medical Group (PMG).
  • Services must be authorized or provided by your PCP or PMG.
  • You do not have the option to seek treatment outside of Kaiser Permanente-contracted facilities, except in emergencies.
Kaiser Permanente
Calendar Year Deductible
Individual $1,000
Family $2,000
Out-of-Pocket Maximum (includes deductible)
Individual $3,800
Family $7,600
Coinsurance 20%
Physician Office Visits
Preventive Care Covered at 100%
Primary Care Visit $20 copay per visit
Specialist Visit $30 copay per visit
Hospital Services
Inpatient Hospitalization 20% after deductible
Emergency Room 20% after deductible
Urgent Care $30 copay per visit
Outpatient Services
X-Ray and Lab Tests $10 copay
Surgery 20% after deductible
Prescription Drugs
Generic $10 copay
  • Formulary/Brand
  • Non-Formulary
  • Specialty
$30 copay
$60 copay
20% up to $250