A Kaiser Permanente – California plan
Kaiser is an HMO (Health Maintenance Organization) with a closed network of providers.
See updated information about coverage for COVID tests.
New for 2024
- Monthly premium costs for employees are increasing by around 26% (for self-coverage or coverage for the employee and children) up to 74% (for coverage of the employee and spouse).
- FDA-approved over-the-counter contraceptive drugs and devices will have $0 cost-share and no prescription requirement.
- Copays will be eliminated for in-network vasectomy services.
- Optum Behavioral Health (which offers behavioral health services in addition to Kaiser) will:
- Eliminate the copay for outpatient intensive ABA therapy for Autism Spectrum Disorder.
- Offer a 12-month membership at no cost to their Self Care mobile app, with curated content to support teens.
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 and urgently needed services.
- Behavioral health benefits are provided by Kaiser and Optum.
Best fit for you if:
- You and the family members you cover live in California
- You want low monthly premiums
- You want low, predictable out-of-pocket costs
- You like having one doctor manage your care
- You are happy with the selection of providers within the Kaiser system
Monthly plan costs
2024 retiree plan costs chart »
Faculty and staff
| Pay Band (full-time salary rate) |
Self | Self + Child(ren) |
Self + Adult |
Family |
|---|---|---|---|---|
| $68,000 and under | $36.49 | $65.60 | $110.33 | $136.84 |
| $68,001–$136,000 | $84.69 | $152.26 | $262.15 | $323.23 |
| $136,001–$204,000 | $134.16 | $241.20 | $398.20 | $496.54 |
| $204,001 and above | $185.38 | $333.30 | $539.17 | $676.08 |
Typical out-of-pocket costs
- Office visits/Urgent care: $20
- Emergency room visits: $125
- Hospital stay: $250
- Prescription drugs: $5, generic; $25, brand name
About Kaiser Permanente Senior Advantage
Kaiser Permanente Senior Advantage is considered the “partner plan” of Kaiser HMO. That means that if you are a retiree enrolled in Kaiser HMO, you’ll be transferred into Kaiser Permanente Senior Advantage when you turn 65, once Medicare has approved your enrollment form.
If you will be Medicare-eligible in 2023 and would like to learn more about Kaiser Senior Advantage, register for a virtual information session.
