Health Plan Overview Kaiser Permanente CA & HI HMO 2024
If you live in California or Hawaii and you’re looking for a medical plan that brings simple, personalized, and hassle-free care and coverage together, then the Kaiser Permanente HMO might be right for you. This plan offers everything you need to stay on top of your health in one easy-to-use package.
How the plan works
The Kaiser plan is a health maintenance organization, or HMO, and features copayments when you receive medical care with no deductibles, lower out-of-pocket maximums at $2,000 individual and $4,000 family, and lower per-paycheck deductions than the POS plan.
Plan Feature | Kaiser CA & HI HMO |
Deductible | $0 |
Coinsurance | N/A |
Primary Care Visit | $20 copay |
Specialist Visit | $20 copay |
Emergency Room | $100 |
Generic Rx | $15 copay |
Formulary & Non-Formulary Brand Rx | $35 copay |
The Kaiser Permanente HMO works differently from our other plans in that participants must use Kaiser providers within designated Kaiser facilities when receiving care in order to receive benefits. With many conveniently located Kaiser facilities to choose from, you can receive every kind of care, including preventive and primary care, urgent care, specialty care like obstetrics and psychiatry, support for ongoing conditions and more.
Kaiser facilities are staffed with doctors from top medical schools, and receiving care within the network of Kaiser facilities means coordinating care is a breeze. Your doctors, nurses, and other specialists are connected to each other, and to you, through your electronic health record, so they know important things about you and your health — like when you’re due for a screening and what medications you’re taking — and they work together to keep you healthy. Kaiser even offers more than one way to get care, including in-person, via phone call or video chat with your doctor, via email or through the Kaiser Permanente app.
Kaiser strives to deliver care that’s sensitive to your culture, ethnicity and lifestyle, with doctors and staff who speak more than one language, telephone interpretation services in more than 150 languages, and training for care teams on how to connect with and care for people of diverse backgrounds
Programs to help you be healthier and happier
Kaiser offers a wealth of health and wellness tools and resources, including:
- Online wellness tools.
- Healthy lifestyle programs.
- Health classes and seasonal farmers markets at Kaiser facilities.
- One-on-one wellness coaching.
- Discounts on services that can help you stay healthy, like gym memberships, massage therapy, and more.
Kaiser participants can take advantage of the healthcare and dependent care flexible spending accounts (FSA), Included Health and the Aetna Resources for Living EAP with TalkSpace.*
Learn more
Visit kp.org or call 1-800-464-4000 (TTY 711), 24 hours a day, 7 days a week to learn more about the Kaiser Permanente HMO. For a more detailed review of the plan’s coverage see this side by side.