Kaiser Permanente HMO
Participants enrolled in the Kaiser Permanente Health Maintenance Organization (HMO) receive all medical treatment from Kaiser physicians, facilities, and pharmacies. The Plan does not cover services rendered by out-of-network providers unless participants require emergency medical care (i.e. ER). You may designate your primary care physician who refers you to specialists within Kaiser.
- Receive all medical, hospitalization and pharmacy services at Kaiser facilities
- Primary care physician refers you to specialists within Kaiser
- Lower premiums
- No deductible
- Low co-pay
- Out-of-pocket limit is $1,500 for individual, $3,000 for family
Other Kaiser benefits include wellness coaching by phone and reduced rates on Class Pass fitness classes.
Refer to the Benefits Compliance Documents web page for a summary of benefits and evidence of coverage. For any coverage questions, please contact Kaiser Permanente directly.
Take advantage of the free tools offered by Kaiser. As a Kaiser participant, register for My Health Manager, and take charge of your health 24 hours a day, 7 days a week. This free online and mobile service allows you to view your and your family members' health information, email your doctor, set appointments, refill prescriptions, and much more. To get started, visit kp.org/registernow.
Download the Kaiser Permanente app for a simple, secure way to manage your health at home or on the go, all in one place.
You have more choices than just the emergency room (ER) that can save you time and out-of-pocket costs. The ER shouldn’t be your first stop — unless there’s a true emergency. While both urgent and emergency care situations are serious, urgent care is for medical symptoms, pain, or conditions that require immediate medical attention but are not severe or life-threatening and do not require use of a hospital or ER. Urgent care conditions include, but are not limited to: earache, sore throat, rash, sprained ankle, flu and fever not higher than 104°. So what do you do when you need care right away, but it is not an emergency?
• Kaiser Permanente Plan Participants – Call Kaiser’s 24/7 NurseLine at 800-464-4000 – Find an urgent care center by visiting kp.org.
Whether you’re traveling domestically or internationally, participation in your Kaiser Permanente medical plan will grant you coverage in the event of a life- or limb-threatening medical emergency.
If you are traveling and receive emergency services, remember to retain all your receipts and related documentation. Call Kaiser Permanente at your earliest opportunity to inform them of any emergency services received.
While traveling domestically, you may be able to seek urgent care either at Kaiser Permanente or other providers' facilities. If seeking services at another provider's facility, you may be asked to pay upfront and claim for reimbursement. Remember to retain all receipts and related documents.
While traveling domestically in other states in which Kaiser Permanente has a presence, you may be able to seek routine care at Kaiser Permanente facilities.
For further information or to confirm coverage, please contact the Kaiser Permanente Away from home Travel Line at 951-268-3900 or review the following resources:
- Web: https://www.kp.org
- Phone: 800-464-4000
- Group no.: 29560
- Kaiser Chiropractic Network (American Specialty Health) phone: 800-678-9133