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BasicsFull-Time Employee * Contribution Per Pay PeriodEmployee Only: $0 Part-Time Employee * Contribution Per Pay PeriodEmployee Only: $196.16 Lifetime maximumPre-Authorization RequirementPre-authorization required for all elective inpatient and outpatient procedures. PENALTY for not pre-authorizing: not covered. Offered ToCare ManagementKaiser Permanente’s Complete Care℠, is a comprehensive multidisciplinary approach to identifying and treating members with chronic conditions. It addresses a wide range of chronic and acute conditions and comorbidities with a focus on prevention, risk reduction, and self-care. The program is integrated into the patient-centered, “whole person” continuum of care provided. Program features include: Multidisciplinary disease management and case management; sophisticated electronic health information management and disease registries; proactive, targeted screening, intervention, and outreach; extensive support for implementing best practices and improved panel management; member self-care tools for improving health and quality of life; and health education to support self-management. Body/DescriptionYou may use only Kaiser Permanente doctors and facilities except in emergencies. Coinsurance100% after applicable co-pays Office co-pay$30 co-pay primary/$50 co-pay specialist DeductibleAnnual maximum$3,500
per individual (in single employee enrollment or in family enrollment) A single Out-of-Pocket Maximum applies to all coverage under the plan, including medical and prescription drugs. (This will cover prescriptions and medical expenses at 100% once the Out-of-Pocket Maximum is met.) X-raysMaternity Hospital Stay$150 co-pay per admission Baby's First ExamBirthing CentersMidwives100% in hospital; if out-patient office visit: $50 co-pay If midwife is available at Kaiser Permanente Prenatal VisitsDoctor Delivery ChargeReproductive HealthMental HealthKaiser Permanente must approve mental health care. OUTPATIENT CARE AutismBehavioral health treatment for pervasive developmental disorder or autism (including applied behavior analysis and evidence-based behavior intervention programs) that develops or restores, to the maximum extent practicable, the functioning of a person with pervasive developmental disorder or autism that meet Kaiser's established criteria (refer to Evidence of Coverage booklet for specifics). The cost sharing for individual and group visits under this Mental Health section apply. Substance AbuseINPATIENT DETOXIFICATION OUTPATIENT CARE Transitional Residential Recovery Services AcupunctureAt a Kaiser facility: Using the American Specialty Health (ASH) network: Allergy TestsAllergy TreatmentAlternative MedicineAmbulance chargesCT ScansChiropractors$20 co-pay Up to 40 combined chiropractic and acupuncture visits per year American Specialty Health (ASH) Plans Participating Chiropractors Christian Science PractitionersCosmetic SurgeryDental TreatmentEmergency Room$200 co-pay (waived if admitted) Urgent Care$30 co-pay at Kaiser Permanente facility Hearing CareExam Network: 100% as part of preventive care Hearing aids not covered Home Health Care100% Up to 100 two-hour visits/calendar year Hospice CareHospital Stay$150 co-pay per admission Infertility Treatment50% Fertility Drugs: Covered under drug benefits at 50%; In Vitro, GIFT, and ZIFT: Not covered. *Artificial insemination and ovulation induction are covered regardless of partner status and without a diagnosis of infertility. Laboratory ChargesMagnetic resonance imaging - MRIDurable Medical EquipmentOccupational TherapyOrgan TransplantsContact Kaiser Permanente for information on transplant coverage benefits Skilled NursingPhysical TherapySurgery : Physician ServicesINPATIENT OUTPATIENT Surgery : Facility ChargesINPATIENT OUTPATIENT Speech TherapyTubal LigationINPATIENT OUTPATIENT Vasectomy$150 co-pay per procedure X-raysPharmacy (Retail)KAISER PERMANENTE PHARMACY Brand: $40 for up to a 30-day supply, $80 for a 31- to 60-day supply, or $120 for a 61- to 100-day supply Mail order drug programKAISER PERMANENTE MAIL ORDER PHARMACY Brand: $80 for up to 100 day supply; Some Specialty drugs are available via mail order, but there is no incentive as you will be paying for the full 100 day supply. Birth Control PillsIncluded in Prescription Drug benefit, covered at 100% Physical exams for adultsPhysical exams for childrenPap smearsMammogramsImmunizations100% Prostate Specific Antigen test - PSAWell-woman visitsVision care100% Eye exams only. Discount program available for vision hardware Does Kaiser cover all of California?Kaiser Permanente service areas include all or parts of: • California • Colorado • Georgia • Hawaii • Maryland • Oregon • Virginia • Washington • Washington, D.C. As a Kaiser Permanente member, you're covered for emergency and urgent care anywhere in the world.
How do I change my location at Kaiser?If you're looking for a new plan in a new location, you can view plans at buy.kp.org or contact us at 1-800-295-8660 or 711 (TTY).
Can I use Kaiser in Northern California?Services covered under your health plan are provided and/or arranged by Kaiser Permanente health plans: Kaiser Foundation Health Plan, Inc., in Northern and Southern California and Hawaii • Kaiser Foundation Health Plan of Colorado • Kaiser Foundation Health Plan of Georgia, Inc., Nine Piedmont Center, 3495 Piedmont ...
Is Kaiser Permanente North or South?Founded in 1945, Kaiser Permanente Southern California, headquartered in Pasadena, comprises: Kaiser Foundation Health Plan, Inc. Kaiser Foundation Hospitals.
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Can you use kaiser northern california in southern california
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