Individual and Family

At Kaiser Permanente, they offer you a range of individual plans from which to choose, so you can select a plan that's right for you and your family. Whether you're looking for lower monthly premiums or broad coverage, our online tools will help you find the Kaiser Permanente plan that fits your budget and lifestyle needs. Kaiser Permanente offers a variety of affordable, quality health insurance plans for you and your family.

Are mammograms covered?

Yes. They are available for no- or low-cost from the first day of coverage. You don't have to meet a deductible first for many preventive services.

Can family members apply for different plans?

Yes. Just complete a separate application for each plan you or your family members apply for.

Does Kaiser Permanente offer plans that are compatible with a Health Savings Account?

Yes. The Kaiser Permanente Insurance Company offers three Individual and Family deductible plans that are compatible with a Heath Savings Account. They are the $0/$1500 Deductible, $0/$2700 Deductible, and the $30/$2700 Deductible Plans with HSA. If you are enrolled in one of these plans and would like to open a health savings account, you may set up an HSA Account with Wells Fargo or the financial institution of your choice.

Are there programs for low-income families?

Kaiser Permanente offers the Step Program for low-income families. For more information on qualification criteria and the application process, please call toll free at 1-800-255-5053. Kaiser Permanente also offers the Child Health Plan program for those 18 and under. For more details on qualification criteria and the application process, please call 1-800-464-4000.

Are there special plans for seniors on Medicare?

The Senior Advantage program combines Medicare and Kaiser Permanente coverage into one, which means more benefits, more convenience, and more services than traditional Medicare. Seniors who are currently on Medicare may apply for Kaiser Permanente's Senior Advantage program. For more information, you may contact Senior Advantage at 1-877-882-2703 or go to www.kp.org/seniors.

What is the cost for a physical exam?

Depending on the plan, a physical would require a low copayment or it would be free. If you are looking at the plan benefits, a physical would be the cost of a "preventative physical exam." Additional costs may apply for any lab or imaging work.

What is meant by "per encounter"?

This is the copayment amount a subscriber pays each time they go in to get X-rays. For example, if a subscriber went in one day and had six X-rays, they would pay $10. Then if the same subscriber went in the next day and had eight X-rays, they would pay another $10.

Are alternative medicine and chiropractic care covered?

The $1,500 Deductible Plan is the only plan that includes chiropractic. Members with this plan have up to 20 chiropractic visits per year for a $15 copayment per visit. In addition, all Kaiser Permanente members can access a select network of complementary health providers to receive a 25 percent discount off regular rates for chiropractic, acupuncture, and massage therapy services.

Do the plans cover vision exams, and optical eyewear?

Depending on the plan, vision exams are covered either for a copay or are completely covered once the deductible is met. Eyewear is not covered. Refer toCopayment Plans Brochure, Deductible Plans Brochure and HSA-Qualified Deductible Plans brochure.

Are prescription drugs covered?

Yes. Some plans cover prescription drugs for a copay. This can be before the deductible is met (most plans), whereas other plans cover prescriptions after the deductible is met (all the HSA plans). The exception to this is the $50 copayment plan which does not cover prescriptions at all.

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