Kaiser Permanente Deductible Plans
These plans offer some of the lowest priced premiums because most services are not covered until after you meet the plans annual deductible.
Kaiser Permanente Deductible Plans – HMO
There are 6 plans to choose from. These plans offer some of the lowest priced premiums because most services are not covered until after you meet the plans annual deductible. You will still however get your no charge preventive benefits like your annual physical exam. You will even be able to visit the doctor or urgent care facility for an office visit copayment and get your prescriptions without being subject to the plans annual deductible (with the exception of the 50/5000 NM plan). These plans generally offer lower monthly premiums in exchange for higher out-of-pocket costs for covered services. Here are the deductible plan highlights:
• Unlimited office visits per calendar year for $20, $25, $30, $40, or a $50 copayment depending upon plan
• Generic drug benefits for a $10 or $35 copayment depending upon plan. No drug benefits are provided on the Deductible 50/5000 NM plan.
• Brand drug benefits for a $35 copayment. No drug benefits are provided on the Deductible 50/5000 NM plan.
• Outpatient Surgery (not an overnight stay) are subject to a $50, $150, $250 or a coinsurance percentage of 20% or 30% after the plans annual deductible depending upon plan.
• Most outpatient X-Rays and lab tests for a $10 copayment after your annual deductible. MRI, CT and PET for a $10 or $50 copayment after the annual deductible depending upon plan.
• Inpatient Surgery (an overnight stay) will be subject to $100, $250, or $500 copayment per day or a 20% or 30% coinsurance percentage depending upon the plan and after the annual deductible. This includes room and board, surgery, anesthesia, X-rays, lab tests, and medications.
• Maternity routine prenatal care visit is no charge. Delivery and inpatient well child care will be subject to a $100, $250, or $500 copayment per day, depending upon the plan after the annual deductible. No maternity coverage is provided on the 50/5000 NM plan.
• Emergency Department visit is a $100 or $150 copayment depending upon plan after the annual deductible but copayment will be waived if admitted.
• Urgent Care visit is a $20, $25, $30, $40, or $50 copayment depending upon plan. With the 50/5000 NM plan you will be subject to a $50 copayment after the plans annual deductible.
• Ambulance Service is a $150 copayment depending upon plan after the annual deductible.
• Annual Out of Pocket Maximum is $2,500, $3,000, $3,500, $4,000, $6,000, or $7,500 depending upon plan. The Out of Pocket Maximums include the plans annual deductible.
When receiving medical attention, you must only use a Kaiser Permanente medical facility unless it is a medical emergency. Click here for Kaiser Permanente physician and location information.
If you need assistance with individual and family plan options and enrollment, call us today at
If applying for a child under the age of 19, you must submit a paper application. No online applications are available for those under the age of 19. Click here to download a paper application that includes submission instructions.