Medical Plan
Kaiser Permanente HMO Plan†
Enjoy a $0 deductible and low annual out-of-pocket maximum. Benefit Tip: This plan does not provide out-of-network coverage, and you must designate a Primary Care Physician before visiting the doctor.
† Available to employees in the following states only: California, Colorado, Mid Atlantic, Georgia, Northwest and Washington.
Kaiser Permanente†* | |||
|---|---|---|---|
In-Network Only | |||
Calendar Year Deductible | |||
Individual | $0 | ||
Family | $0 | ||
Calendar Year Out-of-Pocket Maximum (Includes Deductible) | |||
Individual | $1,500 | ||
Family | $3,000 | ||
Coinsurance/Copays | You Pay | ||
Preventive Care | $0 | ||
Primary Care Physician | $25 | ||
Specialist | $40 | ||
Urgent Care | $25 | ||
Emergency Room | $100 | ||
Inpatient Hospital | $25 | ||
Mental Health & Substance Abuse | You Pay | ||
Inpatient | $12 | ||
Outpatient | $5 | ||
Pharmacy Retail RX (up to 30-day supply) | You Pay | ||
Preventive | N/A | ||
Generic | $10 | ||
Preferred Brand | $35 | ||
Non-Preferred Brand | N/A | ||
Specialty | N/A | ||
Mail Order RX (up to 90-day supply) | You Pay | ||
Preventive | N/A | ||
Generic | $20 | ||
Preferred Brand | $70 | ||
Non-Preferred Brand | N/A | ||
Specialty (30-day supply only) | N/A | ||
*The benefits for Colorado are as follows: Inpatient Hospital is $250 copay. Inpatient Mental Health & Substance Abuse is $250 copay.
† Available to employees in the following states only: California, Colorado, Mid Atlantic, Georgia, Northwest and Washington.
Medical Plan
Kaiser Permanente HMO Plan†
Enjoy a $0 deductible and low annual out-of-pocket maximum. Benefit Tip: This plan does not provide out-of-network coverage, and you must designate a Primary Care Physician before visiting the doctor.
† Available to employees in the following states only: California, Colorado, Mid Atlantic, Georgia, Northwest and Washington.
Kaiser Permanente†* | |||
|---|---|---|---|
In-Network Only | |||
Calendar Year Deductible | |||
Individual | $0 | ||
Family | $0 | ||
Calendar Year Out-of-Pocket Maximum (Includes Deductible) | |||
Individual | $1,500 | ||
Family | $3,000 | ||
Coinsurance/Copays | You Pay | ||
Preventive Care | $0 | ||
Primary Care Physician | $25 | ||
Specialist | $40 | ||
Urgent Care | $25 | ||
Emergency Room | $100 | ||
Inpatient Hospital | $25 | ||
Mental Health & Substance Abuse | You Pay | ||
Inpatient | $12 | ||
Outpatient | $5 | ||
Pharmacy Retail RX (up to 30-day supply) | You Pay | ||
Preventive | N/A | ||
Generic | $10 | ||
Preferred Brand | $35 | ||
Non-Preferred Brand | N/A | ||
Specialty | N/A | ||
Mail Order RX (up to 90-day supply) | You Pay | ||
Preventive | N/A | ||
Generic | $20 | ||
Preferred Brand | $70 | ||
Non-Preferred Brand | N/A | ||
Specialty (30-day supply only) | N/A | ||
*The benefits for Colorado are as follows: Inpatient Hospital is $250 copay. Inpatient Mental Health & Substance Abuse is $250 copay.
† Available to employees in the following states only: California, Colorado, Mid Atlantic, Georgia, Northwest and Washington.
Part-time and Temporary employees are eligible for a limited subset of benefits. Union employees: refer to your collective bargaining agreement for your benefits eligibility.