Kaiser Medical Plan

Kaiser Health Plan

This plan gives you more predictable costs but less flexibility than the HDHP and PPO plans.

Kaiser Health Maintenance Organization (HMO)—California only

You pay a copay for most services, but all care must be received within the Kaiser network. Out-of-network care isn’t covered except in the case of an emergency and you must choose a primary care physician (PCP) to manage routine care, referrals, and hospital stays. Find in-network providers using Kaiser’s provider search.

Note: be sure to select the correct region in the dropdown box at the top of the page.

KAISER HMO

(800) 464-4000
Policy/Group #: 605749
healthy.kaiserpermanente.org

Plan Details

Use this table to review your plan details at a glance.

KAISER HMO
In-Network
Annual Deductible
Individual
None
Family
Annual Out-of-Pocket Maximum
Individual
$1,500
Family
$3,000
Preventive Care
No charge
Primary Provider
$15 copay
Specialist
$15 copay
Infertility Coverage
You pay 50%
Mental Health
Mental/Behavioral Health
$15 copay
Substance Abuse
$15 copay
Diagnostic Lab and X-ray
No charge
Chiropractic Care
$10 copay Up to a combined total of 30 medically necessary
Chiropractic and Acupuncture visits per year
Emergency Room
You pay $100 per visit
Hospitalization
You pay $250 per admission
Outpatient Surgery
You pay $100 per procedure
Prescription Drugs (Pharmacy/Mail Order)
Generic
$10 / $20
Preferred Brand
$20 / $40
Non-Preferred Brand
$20 / $40
Number of Days' Supply
30 days / 100 days

Additional Resources

Virtual Care

The doctor will see you now… anywhere!

Don’t have the time to visit the doctor’s office? Kaiser offers telehealth and virtual care services so you can get the care you need for a variety of minor conditions over the phone, via email, or on a video chat.

  • Phone: Schedule a phone appointment with a doctor or call an advice nurse.
  • Email: Send an email at any time to Kaiser’s care team. Most members receive a reply within 48 hours or sooner.
  • Video: Schedule a video appointment with your doctor, meet with a specialist or have an on-demand video chat with a physician.

Register on kp.org to connect your health plan and access telehealth services.

Explore Virtual Care

Out of Area Coverage

No matter where life takes you, Kaiser Permanente has you covered. If something unexpected happens while you’re away from home, it’s easier than ever to get care. Learn more about your care options (including urgent and emergency care) when traveling outside your home service area.

Kaiser Wellness Coaching

Small changes can make a big difference. Connect one-on-one with a dedicated wellness coach for personalized support and encouragement as you work toward your health goals. Get help eating healthier, becoming more active, managing stress, reaching a healthy weight, quitting tobacco, and more. Available at no additional cost to Kaiser members.

Get One-on-One Support

Documents and Contacts

Transparency in Coverage

This link leads to the machine-readable files made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed amounts between health plans and health care providers. The machine-readable files are formatted to enable researchers, regulators, and application developers to access and analyze data more easily.

Kaiser Machine Readable File

Contact Information

Kaiser HMO

(800) 464-4000
Policy/Group #: 605749
healthy.kaiserpermanente.org

Kaiser App

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