Kaiser Permanente Traditional HMO

Kaiser Permanente HMO

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

How the plan works

You choose a primary care physician (PCP) from Kaiser Permanente’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.

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

Annual Deductible: There is no annual deductible.

Copays: You pay a set dollar amount when you receive medical care.

Annual Out-of-Pocket Maximum: The HMO plans include an annual out-of-pocket maximum. Once you reach the out-of-pocket maximum, the plan pays 100% of covered charges for the remainder of the plan year.