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.
| 2024 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/$3,200 per individual family member/$6,000 per family1 |
| Health Savings Account (HSA) | Yes. You can contribute pre-tax dollars to an HSA through HealthEquity. IRS limits for 2024 are $4,150 (employee only) and $8,300 (family). You can contribute an additional $1,000 if you are age 55 or older in 2024. 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.