You can select this plan if you live in California, Colorado, Oregon or Washington in a Kaiser Permanente service area. The plan exclusively covers you when you use Kaiser Permanente doctors and facilities. Except in the case of an emergency, you’ll pay the full price for any care you receive from a non-Kaiser doctor or facility. To help with your share of costs, this plan comes with a Health Savings Account (HSA) that can contribute to.
| 2025 KAISER HMO WITH HSA PLAN HIGHLIGHTS | |
|---|---|
| Provider network | You may only use Kaiser Permanente doctors and facilities except in emergencies. |
| Primary Care Physician (PCP) to manage care | Optional |
| Referrals needed to see a specialist | For certain specialists |
| Calendar Year Deductible | $3,000 per individual/$3,300 per individual family member/$6,000 per family1 |
| Health Savings Account (HSA) | Yes. You can contribute pre-tax dollars to an HSA through Fidelity. IRS limits for 2025 are $4,300 (employee only) and $8,550 (family). You can contribute an additional $1,000 if you are age 55 or older in 2025. Learn more |
| Coinsurance (You Pay) After Meeting Deductible | 20% |
| Calendar Year Out-of-Pocket Maximum | $4,425 per individual/$4,425 per individual family member/$8,850 per family |
| Preventive Care | Covered in full (calendar year deductible waived) |
| Office Visit (You Pay) | 20%2 |
| Hospitalization | 20%2 |
| Pharmacy Retail (30-day supply) |
Kaiser Permanente pharmacy: specified preventive drugs—100% covered3; generic—$10 copay2; brand—$30 copay2; specialty drugs-20%2 up to $125
|
| Pharmacy Mail Services (up to 100-day supply CA, up to 90-day supply CO, OR, WA) |
Kaiser Permanente pharmacy: specified preventive drugs—100% covered3; generic—$20 copay2; brand—$60 copay2
|
- The family deductible must be met before any person receives benefits.
- After calendar year deductible.
- Calendar year deductible waived.
Stay Informed and Make the Most of Your Health Plan
We want to ensure that you have the resources to take care of your health—anytime, anywhere. Explore the links below to learn how you can get the most out of your health plan with Kaiser Permanente and the variety of care options available to you!
Discover Your Medical Plan Options
Review your regional enrollment brochure to get a full benefit summary, learn how to manage your health virtually, and see the locations of medical offices near you. Click below:
- California – 2025 Ensign Enrollment Brochure.pdf
- Colorado – 2025 Ensign Enrollment Brochure.pdf
- Northwest (Oregon and Southwest Washington) – 2025 Ensign Enrollment Brochure.pdf
- Washington – 2025 Ensign Enrollment Brochure.pdf
Preventive Medications at No Cost
Take a look at the list of preventive drugs available to you at no cost as part of your coverage. See the list of no-cost preventive medications.
Virtual Care at Your Fingertips
Did you know you can email your doctor at no cost, get 24/7 nurse advice, or schedule virtual visits through KP.org? Discover all the ways to access care from the comfort of home.
Traveling? We’ve Got You Covered
Whether you’re traveling across the country or outside of a Kaiser Permanente service area, you can access emergency care anywhere or through the Cigna PPO network. Learn more about your coverage when traveling.
Expecting a Baby?
If you’re expecting, we have resources to support you throughout your pregnancy and beyond. Find out what resources are available for expecting parents.
Explore Wellness Resources
Our wellness guide includes information on a variety of health topics and links to helpful resources such as self-care apps. Access the wellness resource guide.