Kaiser Permanente is a Health Maintenance Organization (HMO) that provides patient services, hospitalization, supplies and prescription drugs through its own network of doctors, hospitals and other Kaiser-affiliated health care facilities.
The Kaiser HMO is one of two health plans offered to employees-only at no cost.
View detailed information about the Kaiser Permanente HMO
Basics | |
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Overview |
You may use only Kaiser Permanente doctors and facilities except in emergencies. There are no pre-existing condition limits or exclusions. Group #7145 (Northern CA) Group #230178 (Southern CA) |
Pre-Authorization Requirement |
Pre-authorization required for all elective inpatient and outpatient procedures. |
Office copay |
$20 copay primary/$50 copay specialist |
Deductible |
No deductible |
Out-of-Pocket Maximum |
$1,500 per individual/$3,000 family |
Preventative Care | |
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Physical exams for adults |
100% |
Physical exams for children |
100% |
Pap smears |
100% |
Immunizations |
100% Office visit copay applies if provided during doctor office visit |
Well-woman visits | 100% |
Prescription Drugs | |
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Pharmacy (Retail) |
Kaiser Permanente Pharmacy |
Mail order drug program |
Kaiser Permanente Mail Order Pharmacy |
Birth Control Pills |
Included in Prescription Drug benefit, covered at 100% |
Traveling Outside the U.S.
Your Kaiser HMO plan provides services in California only. You receive no coverage for routine services outside the service area. However, Kaiser provides “Emergency Care” coverage anywhere you may experience an emergency that is life-threatening in nature.
- View the Kaiser - Coverage When Traveling (MCI International Access) Brochure
- Learn more about traveling outside the U.S.
If you need to file a claim for emergency care received while overseas, download the Kaiser emergency claim form or contact Kaiser to have an emergency claim form sent to you.