Kaiser HMO
A Kaiser Permanente – California plan
Kaiser is an HMO (Health Maintenance Organization) with a closed network of providers.
Changes for 2025:
- Doula services will be covered with no copay, for up to 11 visits per pregnancy.
- The Kaiser HMO network will expand into Monterey County.
- Cost-sharing increases
- Office visit and urgent care copays will increase from $20 to $30 and Kaiser group mental health visits are increasing from $10 to $15.
- Prescription drug copays will increase by $5 for a 30-day supply on existing tiers, and there will be a new specialty drug tier with 30% coinsurance, up to $150 per prescription.
- Optum, which offers behavioral health coverage for Kaiser members (in addition to Kaiser’s coverage), is increasing its emergency room copay to $125 to align with Kaiser’s current copay.
- Full Full eligibility available
- Mid Mid eligibility available
- Core Core eligibility available
- Retirees Retirees eligibility available