Kaiser HMO

COVID-19 update from Kaiser Permanente

  • Kaiser it temporarily closing some medical offices and limiting services at others. Click HERE for the latest facility closures and other updates.
  • For all Kaiser Permanente plans, cost sharing (deductibles, copayments and coinsurance) will be reduced to zero ($0.00) for medically necessary screening and testing for COVID-19 including the visit, associated lab testing, and radiology services in a plan hospital, emergency or urgent care setting, or medical office. If a member is diagnosed with COVID-19, all treatment including but not limited to hospital, transportation and pharmacy services will be covered in accordance with the terms and conditions set forth in the coverage document for the member’s health plan.
  • If you have any further questions, visit KP.org. We also recommend the Centers for Disease Control and Prevention website at cdc.gov for the most up-to-date health advisories and global coronavirus information.

The Kaiser Permanente HMO (group #101728) is a staff model HMO plan which means that it owns its own facilities and employs physicians (Kaiser contracts with Permanente Medical Group). Kaiser Permanente healthcare providers exclusively serve Kaiser plan members. You must choose a Kaiser doctor as your primary care physician to be your first point of contact, and coordinate your care and make referrals. You must receive services from Kaiser, or obtain authorization from Kaiser before obtaining care outside the HMO.

You pay a copayment at the time of service ($25 for a primary care visit; $50 for a specialty visit), then you are covered at 100% of authorized services with no deductibles. For additional details, see the Kaiser Evidence of Coverage.

You pay a $25 copayment for routine eye exams. Optical eyewear is not covered. Coverage for vision care services is provided only at Kaiser facilities. Participants may purchase additional vision care through Vision Service Plan.

Annual out-of-pocket medical and prescription maximums:

  • $3000 maximum – individual
  • $6000 maximum – family

Kaiser facilities are located throughout Southern California – see list on the Kaiser site. To enroll in Kaiser, you must reside within their service area.

You pay $15 per generic prescription and $35 per brand name prescription for up to a 30-day supply at Kaiser Permanente pharmacies. An up to 100-day supply is available through mail order.

Kaiser Permanente | www.kaiserpermanente.org

(800) 464-4000
(800) 788-0616 en Español