Kaiser Individual & Family Plans
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Vision
Vision – Non Kaiser
Member Services
Kaiser Service – try this (800) 789-4661 or the call center @ 800 464 4000 M – F, Saturday or Sunday at 800 773 1370, Spanish 800 788 0616, Chinese 800 757 7585
Kaiser Healthy Life Styles Wellness Programs
Health Care Reform – Mandated Preventative Care
For Better Health Management & Prevention
How about this: more time for what you love.
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
Secure and simple
Registering is simple and only takes a few minutes. In order to make sure your personal health information is secure, we’ll need to ask you a few questions to verify your identity. After you answer the questions, you can choose a password** and start accessing the online features immediately. If you can’t or don’t wish to complete the process online, you can do so by mail.
Take time for yourself. Register today.
Individual Broker Log-In – ONLINE Applications
Kaiser - Get Quote and Enroll ONLINE
Not for Covered CA Subsidies
Broker # 5268
All information is kept safe and secure. View our privacy statement for details.
Paper Application
but ONLINE is faster and better
Here's the Kaiser #Provider 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
get care while away from home. Visit kp.org/travel or call 951–268–3900 for more information.
Membership Agreements – Evidence of Coverage
January 1, 2020 – December 31, 2020
Bronze
- Kaiser Permanente – Bronze 60 HDHP HMO (PDF)
- Kaiser Permanente – Bronze 60 HMO (PDF)
- Kaiser Permanente – Bronze 60 HDHP HMO 6800/40% (PDF)
Silver
- Kaiser Permanente – Silver 70 HMO Off Exchange (PDF)
- Kaiser Permanente – Silver 70 HMO 2500/45 (PDF)
- Kaiser Permanente – Silver 70 HDHP HMO 3000/15% (PDF)
Gold
Platinum
Minimum coverage
Kaiser Playlist –
If you see one that says “Private” just see if you can skip it.
#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
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Enrolling in health plans has helped people focus on their families and careers, and feel protected against unexpected medical issues.
Kaiser
Treatment Cost Estimator Tool
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.
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?
Lastly, where is your office located?
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
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?
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
More detail is on page 58
We pretty much do everything online. Especially considering the very low commissions under ACA/Obamacare. If you want a face to face meeting at our office in San Pedro, use this link to set one https://steveshorr.com/intro/set-a-meeting/
How do I know how much I have to pay for services if I have Bronze plan with say a $6k deductible or Silver with say $2,500?
Here’s a list of Kaiser Prices
See also
info.kaiserpermanente.org/deductibleplans
info.kaiserpermanente.org/deductibleplans/qanda
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?
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.
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.
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?
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.
I’m interested in the HDHP basic bronze plan
It says 40% after deductible for a lot of health issues. How does that work?
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.