Kaiser plan features
- Kaiser is available to California and Washington employees whose home ZIP codes are in Kaiser’s service area.
- Your per-paycheck contributions are higher than the Aetna plans, but when you get care, you pay low copays for most eligible services.
- You must use Kaiser doctors, pharmacies, and facilities, and you may need referrals from your primary care physician. Generally, out-of-network coverage is only available for medical emergencies.
- You can contribute to a Health Care Flexible Spending Account (FSA) with this plan.
|Plan pays 100%
|Office visit, outpatient services
|You pay $25
|You pay $250 per admission
|Diagnostic lab, x-ray, and imaging
|You pay $10 per lab test or x-ray
You pay $50 per MRI, CT, or PET scan
|30-day retail prescriptions
Phone visits are ideal for minor health issues like coughs, colds, flu, and allergies.
Schedule a video visit to meet with a doctor for a mental health consultation or treatment of nonemergency medical conditions, such as rashes, skin infections, eye problems, cuts, and sprains.
To get started, call the phone number on the back of your ID card, 24/7, or log in to your Kaiser account or the Kaiser app to make an appointment.
You’ll need the Kaiser app to access a video appointment from your phone or tablet.
Care from anywhere
Get info, schedule appointments, and fill prescriptions by phone or on your computer. Even better, download the Kaiser app.
Prescriptions are only covered when you use a Kaiser pharmacy or mail-order service.
You’ll pay $15 for generic drugs and $45 for brand-name or specialty medications. If you fill a 100-day supply of a long-term or maintenance prescription, you’ll still pay just $15 for generic drugs and $45 for brand-name or specialty medications.
Preventive care and resources
Registered nurses are on call to answer your health questions and provide general health tips, 24/7. Just call 800-464-4000 in California or 888-901-4636 in Washington.
You can also take advantage of these health and wellbeing resources:
- Complete your Kaiser California health assessment or Washington health profile, and use it as a guide to discuss your health concerns with your doctor.
- Learn about Kaiser’s California wellness resources or Washington wellness resources. They’ve got you covered when you want to learn about conditions and symptoms, improve your nutrition and fitness, or get help with weight management.