Kaiser Health Family Plans 2024 – Pay Bill & Enrollment
Get Information & Enroll
Kaiser 2024 Individual & Family HMO Enrollment Guide Plans #Brochures
- Area Definitions
- Email us [email protected] for other areas
- Glossary of Terms
- Online Application, Quotes & Enrollment
- Kaiser Website - more materials - EOC
- Kaiser Permanente posts $961 million net loss in Q1 Modern Health Care 5.6.2022
- BROKER ONLY Training Guide
All our plans are Guaranteed Issue with No Pre X Clause
Quote & Subsidy #Calculation
There is No charge for our complementary services
Watch our 10 minute VIDEO
that explains everything about getting a quote
- Our Quote Engine Takes all the complexity out of using pencil and paper to figure out the premiums per the Obamacare/ACA rules under CFR §1.36B-3 *
- Get more detail on the Individual & Family Carriers available in CA
Kaiser - Get Quote and #Enroll ONLINE
Not for Covered CA Subsidies
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2022 Paper Application but ONLINE is faster and better
- We are Kaiser Authorized Agents Broker # 5268 and are happy to help you get coverage at no extra charge to you. Kaiser compensates us to help you.
- Appoint us as your Kaiser Broker
- Direct Business ---- Covered CA
- Employer Group [email protected]
- No Extra Charge 17 Reasons how it will benefit you
- Employer Group Quotes
- Individual Quotes & Enrollment - Direct *** Covered CA
Dental & Vision
Vision
Vision – Non Kaiser
#Dental
- KPIC Adult Dental Plan Brochure
- See dental offering in main brochure for Kaiser – scroll or search with CTRL – F
- Delta Dental Ins Main Website – Services Kaiser Plans
- Dental Dental Plan Guide
- Delta Dental PPO Find Dentist
- Our webpage on ALL Companies for Adult Dental
- Mandatory Pediatric Child Vision & Dental
Kaiser Member Services
Find Doctors, Hospitals & Locations
Kaiser - Find MD Doctor Hospital or Locations
Here's the Kaiser #Provider Doctor Search Tool In our example we are search for a psychiatrist in Santa Monica 90404.
After filling in the information, click search. In this case, 70 doctors come up.
Click here to view the results in pdf
- Find doctors & locations
- Passport - Access to Care
- More detail
- Getting care away from home
- Visit kp.org/travel or call 951–268–3900 for more information.
Kaiser Playlist –
If you see one that says “Private” just see if you can skip it.
Would you prefer to file a complaint directly with Kaiser, rather than have us help you no charge, as long as we are your broker?
#Covered CA Certified Agent
No extra charge for complementary assistance
- Appoint us as your broker
- Get Instant Health Quotes, Subsidy Calculation & Enroll
- Videos on how great agents are
Kaiser & Blue Shield
Treatment Cost #Estimator Tool
requires sign in
The tool is for all Kaiser Members that are enrolled on Deductible or Health Savings Account Plans. The cost estimates are for services that are marked "after deductible" to give members an idea of the cost of those services.
- 2021 Kaiser Sample Fee List
- How do I know what level of service I will get billed for?
- BLUE SHIELD Treatment Cost Estimator – for PPO Members
- Cost Helper.com what people are paying for health services
Kaiser #Member Services
- Kaiser Service – 800 464 4000
- Kaiser Resource Guide
- Wellness & Member Tools
- Kaiser Healthy Life Styles Wellness Programs
- Health Care Reform - Mandated Preventative Care
- For Better Health Management & Prevention
- Care away from home – travel
- healthy.kaiserpermanente.org/southern-california/support
- my.kp.org/caps/easy-online-access/
- Member Portal Set Up
- When you register on kp.org, you'll get access to my health manager—the feature that enables you to take care of your health and view parts of your health record, all in one place*. And that frees up time for the fun stuff.
- Once you register, you can:
- e-mail your doctor's office
- view select test results
- order prescription refills (and have them mailed to you, with free shipping)
- request or cancel routine appointments
- review recent past office visits
- see a list of your recent immunizations and allergies
- act for a family member (e-mail your child's doctor, and more)
- receive our monthly e-newsletter
- When you register on kp.org, you’ll get access to my health manager—the feature that enables you to take care of your health and view parts of your health record, all in one place*. And that frees up time for the fun stuff.
- Broker ONLY - Forms Etc.
FAQ’s
- Question – I’m interested in KP Gold 80 HMO, but I do have a few questions.
- How much would I be responsible for if I had a hospital stay of more than five days?
- If I want to add a dental & vision plan do I have to enroll now because of my “qualifying event” or can I do that at any time or must I wait for an open enrollment period?
- Answer — There is no charge after 5 days. See brochure above or excerpt below
- You can enroll in dental and vision, anytime when going direct. If you do Covered CA, they only allow at Open or Special Enrollment.
- See the site map or links above for dental coverage
- Question If I have a medical condition that affects my eyes, like
- Keratoconus (KC) is a disorder of the eye which results in progressive thinning of the cornea.[3] This may result in blurry vision, double vision, nearsightedness, irregular astigmatism,[4] and light sensitivity leading to poor quality-of-life.[3][5] Usually both eyes are affected.[3] In more severe cases a scarring or a circle may be seen within the cornea.[6] wikipedia.org
mayoclinic.org - Will the Kaiser Medical Policy cover it or do I need a vision plan?
- Keratoconus (KC) is a disorder of the eye which results in progressive thinning of the cornea.[3] This may result in blurry vision, double vision, nearsightedness, irregular astigmatism,[4] and light sensitivity leading to poor quality-of-life.[3][5] Usually both eyes are affected.[3] In more severe cases a scarring or a circle may be seen within the cornea.[6] wikipedia.org
- Answer See our vision page where we deal with Medicare and vision issues
- Here’s the summary of benefits for the Blue Shield Vision Deluxe 15/25/150 plan that you also purchased. So, yes, glasses and a comprehensive exam are covered 100% if you use a participating doctor and facility. Do NOT go by our summary, click the link and see what the actual brochure says.
- See the Gold 80 EOC page 15
- So, eye disease is covered by Kaiser Medial, but not routine eye exams. For routine, see your Blue Shield Vision Policy
- Question my son is undergoing a medical condition and needs to be seen through the Children’s Hospital of Orange County https://www.choc.org/
- Kaiser said they won’t pay out of network.
- What can I do?
- Answer Here’s the full EOC – Membership Agreement for the Silver Kaiser Plan. I don’t see a clear answer there on how they might refer you to an out of network hospital. Kaiser will refer you to their own specialists.
- Here’s a Q & A on a Kaiser site that says for rare conditions Kaiser can send you to an affliated provider.
- I guess it boils down to Medical Necessity, if you truly feel Kaiser can’t treat the illness, try Independent Medical Review with CA Department of Health Care.
- KUDOS Steve,
- I’m liking the Kaiser experience.
- The Kaiser cardiologist I was assigned to is an upgrade to the one I was previously seeing. She recv’d her training at three of the best US medical facilities for the treatment of cardiovascular disease.
- Kaiser is built for efficiency and their prescription drug prices are 40% less than what I was paying previously.
- So far, so good.
- Question I am trying to decide between the Bronze and Silver. I need to understand what the percentage copays look like. 15% or 40% of what??
- I was on the phone with Kaiser for an hour and no one could give me an answer. Then they sent me to a cost estimator website that has been retired.
- Recommendations?
- Answer You can do a side by side comparison in our quote engine. If you go to the top of this page, you can get the brochure for your rating area – in your case San Diego. There you can get a side by side comparison, right from an official Kaiser brochure.
- The Bronze Plan has the highest deductible. In the plan you’re looking at, it’s $6,000. When your expenses go over the deductible then Kaiser will pay 60% of your bills and you pay 40%. When your deductible and the 40% reaches $6,650 then Kaiser pays 100%. That’s what OOP or Out of Pocket Maximum is.
- HDHP means High Deductible Health Plan so it qualifies for an HSA – Health Savings Account so that you can use a tax advantaged savings fund to pay claims under the deductible.
- You might consider the Bronze 60 HMO so that you get three doctor visits/year for $75 without a deductible.
- If you click on the link where it says “Plan Details” that will explain the terms and coverage in more detail. Then of course there is the official Kaiser brochure above.
- I’m not sure about a real cost estimator tool, but see above for sample fee lists
News, Resources & Links
https://khn.org/morning-breakout/rising-costs-blamed-for-kaiser-permanentes-4-47-billion-net-loss/
https://www.sandiegouniontribune.com/news/california/story/2022-07-19/newsom-administration-criticism-medi-cal-contract-kaiser-permanente
https://khn.org/news/article/california-medicaid-contract-kaiser-permanente-key-details-missing/
Make a payment
Appoint us as your Kaiser Broker
Direct Business ---- Covered CA
No Extra Charge
17 Reasons how it will benefit you
Kaiser Permanente kp.org – Pay your bill #ONLINE
Where can I login & pay premiums online?
Here’s a rundown of where to make online payments and some basic information for each option.
Plan type | Where to pay |
---|---|
Individual and Family Plan members (KPIF) (payments outside kp.org) |
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Health Insurance Marketplace (Exchange) members (payments outside kp.org) |
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Health Insurance Marketplace (Exchange) members (payments through kp.org) |
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Medi Cal with Kaiser
FYI we don’t get compensated to help you with Medi Cal
#My Medi-Cal
How to get the Health Care
You Need
24 pages
Smart Phones - try turning sideways to view pdf better
-
- More explanation
- Enroll with Benefits Cal
- What is Medi Cal - VIDEO
-
Medi-Cal Managed Care HMO – Health Care Options
Here you can review and choose the HMO that you want to deliver your Medi-Cal health Care.
- California Advancing and Innovating Medi-Cal (CalAIM) is a long-term commitment to transform and strengthen Medi-Cal, offering Californians a more equitable, coordinated, and person-centered approach to maximizing their health and life trajectory.
- Medicaid.gov
- Disability Benefits 101
- Western Poverty Law Center Guide
- Medi-Cal enrollees not sure how to use coverage california health line.org
- Medi Cal only covers outside of CA for emergencies and very special circumstances. Cornel Law *
- Medi-Cal pays $415 to $575/month or MORE to HMO’s to take care of you Learn More⇒ Insure Me Kevin.com 3.4.2016 5.11.2014
- Medi Cal Explained CHCF
- Medi-Cal Facts and Figures, 2024 Edition Gives a lot of information on ALL Health Insurance Programs
- Medi Cal Contact Information
- chcf.org/cal aim-resources-
- cal matters.org/medi-cal-eligibility/
- dhcs.ca.gov/Budget-Highlights
- ebudget.ca.gov/Full Budget Summary
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Prescription drugs.
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- Hearing Aid Cap FAQ's
- Health screenings for kids
- Preventive and wellness services and chronic disease management.
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- Mental Health CHCF Fact Sheet
- Substance abuse CHCF Article
- Maternity
Ongoing Care & Recovery
- Personal care services (IHSS)
- Nutrition Food & Meals
More Details
- My Medi-Cal brochure
- dhcs.ca.gov/Medi-Cal_EHB_Benefits
- dhcs.ca.gov/Benefits_services.aspx
- dhcs.ca.gov/Benefits-Chart
- Check with your HMO Providers Evidence of Coverage
- Insure Me Kevin.com - Medi Cal HMO same coverage as Covered CA HMO! Provider list may differ!
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- Our Webpages on
- Medi Cal Choose HMO PCP Doctor & Insurance Company
- Denti Cal
- Medi-Cal – MAGI Income Eligibility Criteria
-
BIC Benefits Identification Card
https://healthy.kaiserpermanente.org/health-wellness/mental-health