A Kaiser Permanente – California plan
Kaiser is an HMO (Health Maintenance Organization) with a closed network of providers.
Coverage for COVID-19 tests
Through Nov. 11, 2023, Kaiser HMO will continue to cover at-home over-the-counter antigen tests and waive the cost-share for PCR tests if ordered by a physician.
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.
- 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 — 2023
2023 retiree plan costs chart »
Faculty and staff
| Pay Band (full-time salary rate) |
Self | Self + Child(ren) |
Self + Adult |
Family |
|---|---|---|---|---|
| $65,000 and under | $28.87 | $51.97 | $63.24 | $86.30 |
| $65,001–$129,000 | $67.05 | $120.69 | $150.40 | $204.01 |
| $129,001–$194,000 | $106.23 | $191.21 | $228.51 | $313.46 |
| $194,001 and above | $146.80 | $264.24 | $309.44 | $426.84 |
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.