Kaiser Permanente health insurance rates are provided free on our website. You can safely and quickly view quotes for single, family and self-employed plans, and purchase your policy online without paying broker or administrative fees. If your job does not provide medical benefits, you’re a student, or only need coverage for a short period of time, there are many affordable plans to choose from. You can choose one physician for all family members, or a separate doctor or specialist for each family member.
If you have reached age 65, you may be eligible for a quality Medigap plan, or other Senior options. Advantage individual and Advantage Medicare Medicaid options are available in many states. A fixed annual limit on out-of-pocket expenses helps you determine the most cost-effective option. Once you become eligible for Medicare, enrolling in a plan is quick and easy. The Five-Star Quality Rating program also helps you evaluate different plans.
About Kaiser
Kaiser Permanente was founded in 1945 and has become the biggest non-profit healthcare provider in the US, covering more than 12 million people. By combining two organizations (Kaiser Foundation Health And Hospitals, and Permanente Medical Groups), they integrate their own treatment within a network of more than 23,000 loyal doctors, 65,000 nurses, 700 medical offices, 39 hospitals and many other facilities.
Treatment comes first and each nurse, surgeon or any related provider seems to treat their patient as if it is their only one. Also, electronic health record systems provide cutting edge technology that helps with privacy concerns and quickly transferring information in an emergency setting. The Kaiser Permanente app has become extremely popular and allows policyholders to easily refill prescriptions, view test results and manage routine office appointments. Telehealth appointments can also be scheduled.
Although headquartered in California (Oakland), offices are located throughout the country, with the biggest concentration of insured members in California, Colorado, Georgia, Hawaii, Oregon, Washington, Virginia, Maryland, and Washington D.C. Total operating revenue is more than $70 billion with more than $3 billion of net income. Group Health Cooperative was purchased two years ago, which added more than 6,000 new employees and 651,000 new covered members. 2024 policy members exceeds 11 million, and more than 220,000 employees.
Most importantly, they are one of the most innovative carriers in the industry. Several of these innovations include extensive use of telemedicine, the Hereditary Cancer Risk Center, Clinic On Wheels, diabetes identification tools, hunger free programs, “Find Your Words” public health awareness campaign, and environmental projects.
The available US plans include Kaiser Foundation Health Plan in Southern and Northern California, and Hawaii, Kaiser Foundation Health Plan of Colorado, Kaiser Foundation Health Plan of Georgia, Kaiser Foundation Health Plan of Mid-Atlantic States in Maryland, Virginia, and Washington D.C., Kaiser Foundation Health Plan of the Northwest, and Kaiser Foundation Health Plan of Washington. Their biggest market shares are in Georgia and Virginia.
What Type Of Policies Can Be Purchased?
Each plan is an HMO (Health Maintenance Organization) designed to provide maximum benefits with the lowest possible out of pocket risk to the consumers. The local networks will give you a wide range of options regarding the type of treatment you receive and where you go to receive it.
Kaiser HMO Plans Cover Preventive Visits
Coverages are fairly typical of HMO plans. Small co-payments (usually $25 and $35) apply to office visits with physicians and specialists, and both generic and brand-name drugs are included in benefits. As expected, a higher out-of-pocket cost will be associated with non-generic prescriptions, and coverage is delivered on a prepaid basis. Often, ER and Urgent Care visits are subject to only a copay.
Preventive benefits for children and adults do not have to meet a deductible, copay or any other out-of-pocket requirement. In addition to routine annual physicals, immunizations, OBGYN visits, mammograms, scheduled colonoscopies, and many diagnostic testing and x-rays are covered without any required payment. Many additional Senior and pediatric benefits have been added in the last three years.
A primary-care-physician (PCP) is required to help coordinate your treatment. They will also refer the patient to the most appropriate specialist or facility if special care is needed. Since Kaiser has many different locations throughout the country, you may able to receive out-of-state treatment if medically necessary. If an emergency arises, and you are unexpectedly admitted to an ER or hospital, generally, it is considered a “network” visit, even if outside of the treatment area.
Affordable Kaiser Plans For Persons Under Age-65 (2024 Plan availability varies by state, and federal subsidies may reduce premium)
Catastrophic Tier
KP VA Catastrophic/9450 Ded/Vision – $9,450 policy deductible and 0% coinsurance. $0 pcp office visit copay for first three visits. Applicant must be under age 30.
KP MD Catastrophic/9450 Ded/Vision – $9,450 policy deductible and 0% coinsurance. $0 pcp office visit copay for first three visits. Applicant must be under age 30.
KP DC Catastrophic/9450 Ded/Vision – $9,450 policy deductible and 0% coinsurance. $0 pcp office visit copay for first three visits. Applicant must be under age 30.
KP CO Catastrophic – $9,450 policy deductible and 0% coinsurance. $0 pcp office visit copay for first three visits. Applicant must be under age 30.
KP Select CO Catastrophic – $9,450 policy deductible and 0% coinsurance. $0 pcp office visit copay for first three visits. Applicant must be under age 30.
KP GA Catastrophic – $9,450 policy deductible and 0% coinsurance. $0 pcp office visit copay for first three visits. Applicant must be under age 30.
Minimum Coverage HMO – $9,450 policy deductible and 0% coinsurance. $0 pcp office visit copay for first three visits. Applicant must be under age 30.
Basics Plus Catastrophic Plan – $9,450 policy deductible and 0% coinsurance. $0 pcp office visit copay for first three visits. Applicant must be under age 30.
Bronze Tier
KP VA Bronze 7500/40% – $7,500 policy deductible and 40% coinsurance. $65 and $95 office visit copays. Preferred generic drug copay is $18 ($36 mail order). Lab test copay is $40.
KP VA Bronze 6900/0%/HSA/Vision – $6,900 policy deductible and 0% coinsurance. HSA-eligible.
KP VA Bronze 6000/55/Vision – $6,000 policy deductible and 35% coinsurance. $50 pcp office visit copay for first three visits to preferred provider. Copay waived for children under age five. Generic drug copay is $35 ($52.50 mail order). $75 Urgent Care copay.
KP VA Standard Expanded Bronze 7500/50/Vision – $7,500 policy deductible and 50% coinsurance. $50 and $100 office visit copays. Urgent Care copay is $75. Generic drug copay is $25 ($37.50 mail order).
KP Select CO Bronze 8500/50 – $8,500 policy deductible and 50% coinsurance. $50 copay for first pcp office visit. Generic drug copay is $30 ($60 mail order). First Urgent Care visit has a $150 copay.
KP Select CO Bronze 6500/50 – $6,500 policy deductible and 40% coinsurance. $50 pcp office visit copay for first three visits to preferred provider. Generic drug copay is $30. First three Urgent Care visits have a $150 copay.
KP CO Bronze 8500/50 – $8,500 policy deductible and 50% coinsurance. $50 pcp office visit copay for first visit to preferred provider. Generic drug copay is $30. First Urgent Care visit has a $150 copay.
KP Select CO Bronze 6500/35%/HSA – $6,500 policy deductible and 35% coinsurance. Generic drug copay is $35 (after deductible). HSA-eligible.
KP Select CO Bronze 7000/50 Rx Copay – $7,000 policy deductible and 45% coinsurance. $50 pcp office visit copay for first two visits to preferred provider. Generic drug copay is $30. Brand drug copay is $200. Non-preferred brand drug copay is $450. First two Urgent Care visits have $150 copay.
KP CO Bronze 6500/50 – $6,500 policy deductible and 40% coinsurance. $50 pcp office visit copay for first three visits to preferred provider. Generic drug copay is $30. First three Urgent Care visits have a $150 copay.
KP Select Colorado Option Bronze – $7,000 policy deductible and 45% coinsurance. $0 office visit copay for first three visits to preferred provider. Generic drug copay is $30. Brand drug copay is $200. Non-preferred brand drug copay is $350. First three Urgent Care visits have $0 copay.
KP CO Bronze 6500/35%/HSA – $6,500 policy deductible and 35% coinsurance. Generic drug copay is $35 (after deductible). HSA-eligible.
KP CO Bronze 7000/50 Rx Copay – $7,000 policy deductible and 45% coinsurance. $50 pcp office visit copay for first two visits to preferred provider. Generic drug copay is $30. Brand drug copay is $200. Non-preferred brand drug copay is $450. First two Urgent Care visits have $150 copay.
KP GA Signature Bronze Virtual Complete 5500/60 – $5,500 policy deductible and 30% coinsurance. $60 pcp office visit copay for first pcp three visits. Generic drug copay is $30 ($60 mail order). Urgent Care visits have $100 copay. Lab tests covered at 100%.
KP GA Signature Bronze 6500/40%/HSA – $6,500 policy deductible and 40% coinsurance. HSA-eligible.
KP GA Signature Standard Bronze 7500/50 – $7,500 policy deductible and 50% coinsurance. $50 and $100 office visit copays. Generic drug copay is $25 ($50 mail order). Urgent Care visits have $75 copay.
Silver Tier
KP Virtual Plus Silver – $3,000 policy deductible and 30% coinsurance. $20 and $40 office visit copays . $20 Urgent Care copay. $10 generic drug copay.
KP GA Signature Silver 4500/35 – $4,500 policy deductible and 35% coinsurance. $35 and $65 office visit copays . $100 Urgent Care copay. $10 generic drug copay.
KP Flex Silver HD – $3,000 policy deductible and 30% coinsurance. $30 copay for first three pcp office visits. $20 Urgent Care copay. Tier 1 and Tier 2 drug copays are $5 and $15.
KP Silver HSA – $3,000 policy deductible and 10% coinsurance.
KP GA Signature Silver 3500/20%/HSA – $3,500 policy deductible and 20% coinsurance.
KP Flex Silver – $1,800 policy deductible and 30% coinsurance. $20 and $45 office visit copays for the first four visits. Generic drug copay is $25.
KP Cascade Silver – $2,000 policy deductible and 30% coinsurance. $25 and $65 office visit copays. Urgent Care copay is $60. Generic and preferred brand drug copays are $20 and $70.
KP Silver 70 HMO – $4,000 policy deductible and 20% coinsurance. $40 and $80 office visit copays. Urgent Care copay is $40. Generic and preferred brand drug copays are $16 and $60. Non-preferred brand drug copay is also $60.
Gold Tier
KP Flex Gold – $1,150 policy deductible and 30% coinsurance. $20 and $45 office visit copays for the first five visits. $45 Urgent Care copay. Preferred generic and preferred brand drug copays are $10 and $40.
KP Cascade Gold – $500 policy deductible and 20% coinsurance. $15 and $40 office visit copays. Diagnostic lab and radiology visit copays are $20 and $30. Urgent Care copay is $35. Preferred generic, preferred brand, and non-generic drug copays are $10, $60, and $100.
KP Gold 80 HMO Coinsurance – $0 policy deductible and 20% coinsurance. $35 and $65 office visit copays. Diagnostic lab and radiology visit copays are $40 and $75. Urgent Care copay is $35. Generic, preferred brand, and non-preferred brand drug copays are $15, $55, and $55.
KP Gold 80 HMO 250/35 – $250 policy deductible and 20% coinsurance. $35 and $55 office visit copays. Diagnostic lab and imaging visit copays are $35 and $250. Urgent Care copay is $35. Generic, preferred brand, and non-preferred brand drug copays are $15, $40, and $40.
KP Gold 80 HMO 0/30 – $0 policy deductible and 20% coinsurance. $30 and $35 office visit copays. Diagnostic lab and imaging visit copays are $35 and $250. Urgent Care copay is $30. Generic, preferred brand, and non-preferred brand drug copays are $15, $40, and $40. $250 ER copay.
Platinum Tier
KP Platinum 90 HMO – $0 policy deductible and 10% coinsurance. $15 and $30 office visit copays. Diagnostic lab and imaging visit copays are $15 and $75. Urgent Care copay is $15. Generic, preferred brand, and non-preferred brand drug copays are $5, $15, and $15. $150 ER copay.
KP HI Platinum 0/10 – $0 policy deductible and 20% coinsurance. $10 and $20 office visit copays. Diagnostic lab and imaging visit copays are $10. Urgent Care copay is $10. Generic, preferred brand, and non-preferred brand drug copays are $5, $45, and $45. $250 ER copay.
KP HI Platinum 0/10 Plus CAM – $0 policy deductible and 20% coinsurance. $10 and $20 office visit copays. Diagnostic lab and imaging visit copays are $10. Urgent Care copay is $10. Generic, preferred brand, and non-preferred brand drug copays are $5, $45, and $45. $250 ER copay.
KP Platinum 0/15 Vision – $0 policy deductible with $15 and $20 office visit copays. Diagnostic lab and imaging visit copays are $20 and $250. Urgent Care copay is $20. Generic, preferred brand, and non-preferred brand drug copays are $5, $35, and $55. $300 ER copay.
What Are Some Advantages To Having An HMO?
One of the most common advantages is cost. Typically, premiums are lower since the network of providers can offer very steep discounts, which then reduces rates. Also, treatment is often more personalized, since you coordinate your healthcare with a Primary Care Physician (PCP). Regarding price and cost, these types of policies also tend to increase at a slower pace than other more traditional options. The size of available networks has been increasing since they first became available.
NOTE: Maternity benefits were always traditionally more available and less expensive with an HMO. However, beginning five years ago, Exchange PPO, HMO and other comprehensive plans were also required to include maternity benefits. This addition was part of the ACA or PPACA (Patent Protection And Affordable Care Act) legislation that was passed in 2010. However, out-of-pocket costs, and copays will vary depending on the individual or group contract.
An HMO plan provides helps the members of the plan and the sponsors of the plan (Kaiser). Along with less expensive rates, guaranteed availability of quality healthcare services is provided. Member costs are reduced by negotiating with physicians and other medical facilities. The network providers also enjoy a consistent flow of patients, while plan members typically have little or no paperwork to file. Claims are processed easily and efficiently.
Are Both Individual And Business Plans Available?
Yes, they are. Individual and family coverage can be purchased. But also, if you own a business, whether you have a few employees or a few hundred, you can apply for a policy for yourself and your workers. There are many participating labs and pharmacies that make it easier for any person that has a pre-existing conditions or needs future treatment. If you prefer, most of the paperwork can be handled online, so you have more time to manage your business or your household.
However, rates and benefits changed five years ago when the State Marketplaces went into effect. You can find more information about the Health Insurance Exchange and some of the most significant changes. Your premiums are now also impacted by federal tax subsidies and new mandates that require essential benefit packages to be included on all new policies. Although most of these benefits were already included, there are a few that were not previously covered.
What Previously Happened In Ohio?
Previously, Kaiser sold their Northeastern Ohio block of business to Catholic Health Partners (CHP), one of the biggest healthcare systems in the US. More than 30,000 employees worked for CHP in Ohio and Kentucky, and they were well-positioned to move into the northern part of the state.
Five years ago, CHP officially changed its name to Mercy Health, which owns and operates five major hospitals in the state, and is the fourth-largest employer in the Buckeye state. Recently, Mercy (Cincinnati) was named one of the Top 15 health systems by Truven Health Analytics. Truven researched patient satisfaction, cost, and operational efficiency data from more than 2,800 hospitals.
Can I Buy A Medicare Health (Medigap) Plan?
Kaiser Has Medicare Plans
Yes. For more than 40 years, they have offered or participated in Medicare plans. In most states, Kaiser has the highest-rated policy available to consumers. Policies are rated by the Center For Medicare And Medicare Services from 1 star to 5 stars. Previously, only 11 plans (nationally) that offer drug coverage were given the highest 5-star ranking. Six of those were Kaiser’s.
These ratings are updated every year and are based on a wide range of criteria. Among the most stringent factors used are complaint and appeal information, Monitoring data from Medicare itself, requested data from CAHPS (Consumer Assessment of Healthcare Providers and Systems), and separate satisfaction surveys.
The states with the six recognized contracts are Georgia, Maryland, Virginia, District Of Columbia, Oregon, California, Washington, Ohio, Hawaii, and Colorado. There are numerous studies that show that consumers embrace these Senior plans and are very satisfied with the benefits they provide. NOTE: HMO plans are offered in California, Georgia, Washington, Oregon, Hawaii and Colorado. However, in the District of Columbia, Maryland, and Virginia, the policy is a “Cost” plan with a Medicare contract.
Available Medicare Advantage plans include Senior Advantage LA – Orange County, Senior Advantage Basic Sacramento-Sonoma, Senior Advantage Inland Empire, Senior Advantage Basic Kern, Senior Advantage Enhanced Kern, Senior Advantage Core, Senior Advantage Silver, Senior Advantage Gold, Advantage Standard MD, Advantage w/o Part D, and Advantage High MD.
NOTE: To qualify for this type of Senior coverage, you must be 65 or older, unless you are disabled and are able to meet specific exceptions. You must have Parts A and B to enroll in Part D (prescription drugs).
Kaiser Permanente Senior Medicare Advantage Plan Monthly Rates
Georgia -$0 – Senior Advantage Care Plus, $0 – Senior Advantage Liberty, $0 – Senior Advantage Basic 1 ,$0 – Senior Advantage Basic 2, $20 – Senior Advantage Enhanced 2, and $66 – Senior Advantage Enhanced 2.
Washington – $76 – Medicare Advantage Basic, Medicare Advantage Harbor, Medicare Advantage Key, Medicare Advantage Essential, Medicare Advantage Optimal, and Medicare Advantage Vital.
Maryland (Most Counties) – $0 – Advantage Liberty, $0 – Advantage Value, $27 – Standard MD, and $136 – High MD.
Oregon – $0 – Senior Advantage Value Lane, $42 – Senior Advantage Standard, $47 – Senior Advantage Standard Lane, $127 – Senior Advantage Enhanced, and Senior Advantage Value.
Virginia – $0 – Medicare Advantage Value, $0 – Medicare Advantage Liberty, $17 – Medicare Advantage Standard, $30 – Medicare Advantage Care Plus, and $139 – Medicare Advantage High VA.
Northern Colorado – $0 – Senior Advantage Core and $40 – Senior Advantage Silver
Southern Colorado – $0 – Senior Advantage Core and $59 – Senior Advantage Silver
My Health Manager
“My Health Manager” is a tool provided to all current members. It’s a centralized resource that contains information on status of pending treatment, medical records, upcoming appointments, and a total health assessment. You can also pay medical bills online and view specific breakdowns of cost. Shopping for new plans and obtaining quotes is also offered, although utilizing an independent broker provides quotes from all carriers.
The “appoint center” function allows you to quickly schedule appoints online with your PCP or a specialist. You can also view future or past appointments, and make any needed changes. A pharmacy center is included that allows customers to manage their prescription drugs and obtain updated information about their current medications.
The Kaiser mobile app provides additional information and data. Customers can view lab results, email their physician and specialist’s offices with non-emergency questions, refill minor prescriptions, view billing statements and submit payments, and schedule appointments. The app is available at no cost through the Apple store. An online account must be created.
Kaiser Business And Employee Insurance
Small business, large business, multi-state, and national business, labor and trust funds, and Group Medicare plans are available.
Small business plan options include traditional HMO plans, deductible HMO plans, HSA-qualified deductible HMO plans, deductible HMO with HRA plans, PPO plans, and POS plans. In Colorado and California, a small business consists of 2-100 employees. In Georgia, Hawaii, Maryland, Oregon, Washington, Virginia, and the District of Columbia, a small business consists of 2-50 employees. Popular options are shown below:
KP Gold 80 HMO 0/30 – $0 deductible with $30 and $55 office visit copays. Generic maintenance and generic other brand prescription drug copays are $15 and $55.
KP Gold $20 – $0 deductible with $20 office visit copays. Generic maintenance and generic other brand prescription drug copays are $3 and $25.
KP Platinum $15– $0 deductible with $15 and $20 office visit copays. Generic maintenance and generic other brand prescription drug copays are $3 and $10.
KP Silver 2000/35/50/S6 – $1,750 deductible with $50 and $70 office visit copays. Generic maintenance and generic other brand prescription drug copays are $5 and $20.
KP Silver PPO 2000/35/50/S6 – $2,000 deductible with $50 and $75 office visit copays. Generic maintenance and generic other brand prescription drug copays are $5 and $20.
KP Bronze 5250/20/40/S6 – $5,250 deductible with $40 and $60 office visit copays. Generic maintenance and generic other brand prescription drug copays are $5 and $20.
KP Bronze 6000/20/50/S6 – $6,000 deductible with $50 and $70 office visit copays. Generic maintenance and generic other brand prescription drug copays are $5 and $20.
KP Bronze 60 PPO 6300/75 – $6,300 deductible with $75 and $105 office visit copays. Generic maintenance and generic other brand prescription drug copays are $15 and $30.
Health And Wellness
Health and wellness programs have been established for clients, patients, insured persons, and employees of Kaiser. Emotional, mental, and illness assistance is provided at multiple levels. “Living Healthy” techniques and guidance are offered through comprehensive guides. Topics include alcohol, child and teen health, mental wellness, fitness, life planning, men’s and women’s health, nutrition, pregnancy, smoking cessation, senior issues, and weight management.
Classes and programs are offered, including online programs and discounted rates at Kaiser medical centers. Included benefits are support groups, wellness coaching, total health assessments, Managing ongoing conditions (diabetes, insomnia, depression, and chronic pain), and community support, including financial assistance.
Charitable Health Coverage Program
Through this program, medical coverage is offered to low-income household that are not able to acquire private or government-provided benefits. Policy premiums, copays, deductibles, and other out-of-pocket expenses are paid by subsidies. Federal Poverty Guidelines determine eligibility of applicants. Eligibility requirements and enrollment dates are subject to change. Current programs are listed below:
Northern California – Community Health Care Program
Southern California – Child Health Program
Colorado – Colorado Bridge Program
Georgia – Bridge Program
Maryland And Virginia – Community Health Access Program
Oregon – Child Health Program Plus
Group Medicare Coverage For Retired Employees
Managing Medicare costs and providing quality benefits are possible through Kaiser. Levels of benefits and amounts of contributions can be customized. Although electronic monthly payments are popular, a direct billing option is also offered. HRA (Health Reimbursement Arrangement) offer tax-free funds to pay for qualified expenses and policy premiums. More than 1 million Seniors are covered by a Kaiser Medicare plan.
What’s The Latest News?
The medical school will provide free tuition to the first five classes. The school is located in Pasadena and the initial class will begin in the summer of 2020. The large network of facilities and hospitals will be utilized.
Recently, Kaiser was named one of the Top 50 companies for diversity. They earned a Number 3 ranking on the DiversityInc survey. About 900 companies were considered as diversity management continues to grow in importance within the healthcare industry.
Specifically, Kaiser earned Top-10 rankings for the hiring and treatment of Latinos, Asian Americans, people with disabilities, Blacks and executive women. And, although unrelated, KP was named as the top HMO in Southern California. Note: The Kaiser Health News website provides news, updates, and commentary for consumers and businesses.
Past Updates
About 900 new jobs will be created in Atlanta when Kaiser’s new technology center is ready later this year. Georgia state tax credits and grants may pay a substantial portion of the initial expenses. The area is already the home to several medical schools and the Centers for Disease Control And Prevention.
Most of the new hi-tech jobs will be related to cyber security, patient medical records data, development of software, back-office infrastructure, and smartphone identification systems. After the expansion is completed, more than 4,000 workers will be employed in the immediate area.