Kaiser Permanente is a health insurance carrier providing HMO and high deductible plans. Kaiser Permanente has a reputation for offering affordable health insurance. It also provides charitable plans and plans for seniors and lower-income individuals.
The selection isn't the same in every location, so it's essential to consider your options when looking for coverage available where you live.
Is Kaiser Permanente good insurance?
Available in 8 states and Washington, DC, with variations based on plan types
Members can access a broad range of health and wellness resources
Emergency and urgent care covered anywhere in the world
Kaiser Permanente started in 1945. It is typically regarded as a company excelling in customer satisfaction. It is known for issuing health insurance policies at lower rates than others. Kaiser Permanente's health insurance plans allow policyholders coverage for inpatient and outpatient services, ambulance transportation, and medications. It has been named one of the best health insurance companies in 2024 because of its affordability and for insuring those who can't afford traditional health insurance.
Kaiser Permanente offers individual and family plans and policies for those eligible for Medicare and Medicaid. Depending on the person and where they live, policies may differ regarding costs and benefits. Many of its plans structure their costs and coverage to match the needs and preferences of policyholders.
Pros and cons of Kaiser Permanente health insurance plans
Kaiser Permanente is a nonprofit organization providing health insurance plans in eight states and Washington, D.C. It also offers charitable coverage for those who cannot afford health insurance. However, the plan selection will vary by zip code, and not all types of coverage are available in all areas.
Where does Kaiser Permanente operate?
Kaiser Permanente offers health insurance coverage to individuals residing in the District of Columbia and the following states:
Despite only operating in eight states and Washington, D.C., Kaiser has a relatively large network and many individuals served. According to Kaiser Permanente's website data, the company has 40 hospitals and 618 medical facilities and covers 12.6 million individuals. This company pays for care provided by 75,000 allied health professionals, 68,218 nurses, and over 23,982 physicians of the Permanente Medical Groups.
Kaiser Permanente plans: coverage options
Kaiser Permanente's coverage options include coverage through employers, and individual plans, such as copay, deductible, virtual, HSA-qualified, and catastrophic plans organized into tiers corresponding to premium costs, deductibles, and level of coverage.
Kaiser Permanente also offers plans for those eligible for Medicare and Medicaid. With these plans, policyholders can get coverage for preventive and diagnostic services, routine appointments, inpatient care, and medications.
Individual plans have different magnitudes of coverage separated into four "tiers": bronze, silver, gold, and platinum. Each comes with its coverage level to meet the policyholder's needs and preferences. The higher the tier, the higher the premium will be, but a plan in a higher tier will cover a more significant share of the costs compared to lower tiers.
For instance, bronze plans have the lowest premiums but the highest deductibles, copayments, and coinsurance costs. On the other hand, gold and platinum plans have higher monthly premiums but feature lower deductibles, copayments, and coinsurance costs.
Kaiser Permanente offers Medicare Advantage plans that cover inpatient and outpatient services and may include coverage for prescription medications. Its Medicare Advantage policies are typically HMO and HMO-POS plans (and HMO D-SNPs for individuals with dual eligibility for Medicare and Medicaid).
They may offer extra benefits like dental, vision, and hearing. Transportation, fitness benefits, over-the-counter drugs, telehealth visits, and emergency coverage are other benefits that may or may not be included in your plan.
Several of its Medicare plans have $0 premiums. However, this can vary depending on what's offered in your zip code, income and other qualifying factors. Various policies have their copayment amounts per visit to a primary care doctor. Copayments per visit to a specialist may vary, too.
Medicaid plans have different eligibility requirements depending on the state you reside in. Eligibility requirements are based on income and resources. Some states have unique names for their Medicaid programs. For example, Medicaid in California is known as "Medi-Cal," and Colorado's Medicaid program is known as "Health First Colorado."
This program is designed to help low-income individuals and families obtain health insurance at a rate that is either free or low-cost. Coverage may include items such as child care, lab tests, mental health services, counseling for substance abuse problems, outpatient treatments, maternity services, inpatient hospitalization, and medications.
With individual insurance, plans with low copayments have higher deductibles, and plans with higher copayments have lower deductibles. In the case of Kaiser Permanente's copay plans, this coverage has a higher premium but no deductible. Those who enroll in this coverage can receive medical services at coinsurance rates without paying a deductible beforehand.
Policyholders who opt for this type of plan may choose this due to conditions requiring more frequent medical treatments or office visits. Kaiser Permanente describes its copay plans as among the simplest of its coverage offerings.
Deductible plans feature lower monthly premiums but have higher deductible rates. You may have to cover all charges for your medical care before your coverage kicks in. However, in some situations, a plan may allow you to receive certain services, such as medications and office visits, at the plan's coinsurance rates before meeting the deductible.
However, most services require covering all costs until you reach your deductible. The deductible will vary based on your specific plan, and your options will be determined by the plans available in your zip code.
Virtual plans are deductible plans, which entail lower premiums and higher deductibles. Policyholders who enroll in virtual plans will have lower copay and coinsurance costs for preventive and primary care via telehealth consultations than in-person appointments. Virtual plans cover telehealth services that address several types of medical conditions.
This form of health insurance coverage combines low-cost services with convenience, as those enrolled in Kaiser Permanente's virtual plans can access no-cost virtual care options. Although this policy primarily focuses on lowering costs for telehealth appointments, this plan also offers coverage for in-person visits.
HSA qualified plans
This plan will enable you to pay for your healthcare services using a special savings account known as a health savings account (HSA). You won't owe income taxes on the funds accrued in this account, and the amount left at the year's end will roll over to the following year. You can use the funds to cover expenses such as coinsurance, copayments, and deductibles. You may be able to use this for certain services that aren't covered under your plan, such as dental.
Catastrophic plans have a more limited availability compared to Kaiser Permanente's other health insurance plans. This is only available in some markets within the geographic locations where Kaiser Permanente operates. If this plan is available in your area, you may be able to get a catastrophic plan if you are under 30.
If you're over 30, you may be able to enroll if you have a hardship exemption. This is a high-deductible plan. Its monthly premiums are low, and certain services may be available at coinsurance rates before the deductible is met.
How much is Kaiser insurance?
Kaiser insurance costs differ between locations and individuals. These are sample costs for a 35-year-old in Los Angeles (90001 zip code). The costs shown here are based on Kaiser Permanente's HMO plans, and this also shows the differences between tiers regarding rates and cost-sharing for individual and family plans.
|Out of Pocket Maximum
|Bronze 60 HMO
|Plan pays 60% of covered medical expenses
|$6,300 (individual) / $12,600 (family)
|$9,100 (individual) / $18,200 (family)
|Bronze 60 HDHP HMO (HSA)
|Plan pays 60% of covered medical expenses
|$7,050 (individual) / $14,100 (family)
|$7,050 (individual) / $14,100 (family)
|Silver 70 HMO 2850/50
|Plan pays 70% of covered medical expenses
|$2,850 (individual) / $5,700 (family)
|$8,750 (individual) / $17,500 (family)
|Silver 70 HDHP HMO 3600/25% (HSA)
|Plan pays 70% of covered medical expenses
|$3,600 (individual) / $7,200 (family)
|$7,200 (individual) / $14,400 (family)
|Gold 80 HMO
|Plan pays 80% of covered medical expenses
|$8,700 (individual) / $17,400 (family)
|Platinum 90 HMO
|Plan pays 90% of covered medical expenses
|$4,500 (individual) / $9,000 (family)
Where can you get cheap Kaiser Permanente health insurance?
For the cheapest monthly rates on Kaiser Permanente health insurance, it would be advised to get bronze tier plans. Costs typically vary between individuals and geographic locations. For a 35-year-old single male in Atlanta, Georgia (zip code 30301), Kaiser Permanente offers the second least expensive monthly rates on health insurance coverage ($374.27), with Oscar Health Plan of Georgia being the cheapest at $341.94 per month.
For that same individual looking for a policy in Denver, Colorado (zip code 80012), Kaiser Permanente offers its monthly coverage for $299.91. Elevate Health Plans is the only insurance carrier offering a cheaper option ($283.53 monthly).
Kaiser Permanente is among the least expensive insurance carriers in these areas.
Kaiser Permanente reviews and ratings
Kaiser Permanente has gained an overall positive reception, praising customer satisfaction. In J.D. Power's 2023 study of the health insurance companies with the highest customer satisfaction, Kaiser Permanente ranked number one in California, Colorado, Maryland, and the South Atlantic region. It also placed second in highest overall customer satisfaction for health insurance companies in the Northwest.
In Consumer Advocate's review, Kaiser Permanente was considered a solid starting point for individuals seeking health insurance. This review also cited Kaiser Permanente's extensive network of providers as one of its best strengths. However, the commenters on the page were critical of Kaiser Permanente due to appointment scheduling difficulties when trying to see specialists. Some noted a decline in quality over time.
Many of its Medicare policies have earned 4 and 5-star ratings (on a 5-star rating system), but this is based on specific plans within specific geographical areas, not Kaiser Permanente as a whole.
How to know if I am eligible to enroll in Kaiser Permanente health plans?
Individuals can enroll in Kaiser Permanente health plans during the open enrollment period. Some states have open enrollment from November 1 to January 15, while others have it from November 1 to January 31.
The plans you're eligible for will depend on the eligibility criteria you meet for different plans.
- For instance, if you're 65 or over, you could join a Medicare plan.
- If you earn below a certain income level, you can get Medicaid.
- You can join individual or family plans offered in your zip code for other plans.
- You can also enroll when you have a qualifying life event, such as losing a job and getting married or divorced.
If you live in one of its service areas, Kaiser Permanente is worth considering. However, it's a good idea to research all plans available in your zip code before enrolling in a policy from any company to ensure that you're getting the best coverage possible.
Does Kaiser Permanente offer HMO plans?
Kaiser Permanente's health insurance coverage includes HMO plans, as well as high deductible HMO plans and HMO-POS plans. These plans typically do not allow for out-of-network coverage, and they may also feature an in-network out-of-pocket maximum. The amount of coverage offered will also depend on the tier the plan is in.
How much does Kaiser insurance cost per month?
Monthly costs vary by plan, geographical location, and what tier your plan is in. While there are plans with $0 premiums (such as Medicare Advantage), there are also plans with higher premiums - namely, those in the higher tiers with lower deductibles.
What insurance does Kaiser Permanente accept?
This can depend on the area you're getting service. For example, if you were to get treated in one of its hospitals in Oregon or Washington, you could use coverage such as employer-sponsored PPO plans from Cigna and First Choice Health Network.
Does Kaiser Permanente offer affordable plans?
Yes. Regarding low-cost coverage, Kaiser Permanente often has lower monthly costs than most other companies in its operating areas. For individuals on Medicare and Medicaid, Kaiser Permanente has many $0 per month Medicare Advantage plans.
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