Kaiser Permanente Traditional HMO

Kaiser is an HMO (Health Maintenance Organization) with a closed network of providers.

How the plan works

  • You choose a primary care physician (PCP) from Kaiser’s network.
  • The PCP coordinates your care and refers you to specialists.
  • The plan covers the cost of services only when your primary care physician authorizes it.
  • Kaiser provides coverage for services outside of the network only in cases of emergency.

Doctors/Other Medical Care Providers: You can only use doctors,  hospitals, and pharmacies that participate in the HMO network.  Doctors who participate in the HMO network are called in-network providers. There is no coverage if you go to out-of-network providers, except for emergency services.

Annual Deductible: You don’t need to pay an annual deductible before the plan begins to pay for a portion of covered medical services.

Copays: When you receive medical care, you pay a set dollar amount called a copay.

Annual Out-of-Pocket Maximum:  The HMO plans include  an annual  out-of-pocket maximum. This is the maximum amount you must pay out of your own pocket for  copays  during  the  plan  year. Once you reach the out-of-pocket maximum, the plan pays 100% of covered charges for the remainder of the plan year.

 

Per Pay Period Cost

 

 

 

 

 

Employee                 Employee                    Employee          

    Only                         Plus 1                        Plus 2 more

 

Kaiser Permanente Trad HMO   $245.04 $490.08

  $693.47

 

 


 
Resources

Kaiser Permanente Traditional HMO Summary of Benefits and Coverage

Traditional Medical Plans Comparison Chart

Kaiser Permanente Traditional Plan Evidence of Coverage

SD Facility Directory Listing

Kaiser Permanente Online Health Manager

Kaiser Permanente Group Agreement

KP Now - Talk to a doctor within an hour

KP Video Appointments

New Viewridge Medical Offices

 

Contact the Provider

Kaiser Permanente Website

Phone Number: 800-464-4000

Group Number: 104301-02

 

 

Back to Medical Plans