Kaiser Permanente
800-464-4000
Group Number: 979
Kaiser Permanente Health Maintenance Organization (HMO) Plan exists to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. This plan is ideal if you prefer a lower payroll deduction and are comfortable with a PCP directing your care. This is the only health care plan that included vision coverage. Kaiser HMO provides coverage only in Northern California.
|
KAISER MEDICAL PLAN |
Kaiser |
|---|---|
| Annual Deductible | |
| Individual | None |
| Individual within Family | None |
| Family | None |
| Annual Out of Pocket Maximum | |
| Individual | $1,500 |
| Family | $3,000 |
|
Medical Services |
|
| Primary Care Visit | $20 copay |
| Specialist Office Visit | $20 copay |
| Basic X-ray and Laboratory | No charge |
| Inpatient Hospital | $250 copay per admission |
| Emergency Room | $50 copay |
| Urgent Care | $20 copay |
| Chiropractic/ Acupuncture | $15 copay per visit to 30 visits per year |
| Hearing Aid | $2,500 per device, 2 devices every 3 years |
| Prescription Drugs | |
| Generic / Tier 1 | $10 copay |
| Formulary / Tier 2 | $25 copay |
| Specialty | 20% coinsurance up to $200/prescription |
| Semimonthly Employee Contribution | |
| Employee Only | $36.84 |
| Employee + 1 | $205.37 |
| Employee + Family | $309.77 |