Your health care plan with Kaiser Permanente is more than just health coverage — it’s a partnership in health. It connects you to a group of physicians, services, and tools that help you live your healthy best. Plus, you get most preventive care services at little to no cost.
| Active employees | In-Network |
| Primary care visit | $15 |
| Specialist visit | $20 |
| Preventive care | $0 |
| Most lab tests and X-rays | $0 |
| Most generic (30-day supply at medical center pharmacies, or up to 90-day supply for 2 copays)1 | $20 |
| Preferred brand (30-day supply at medical center pharmacies, or up to 90-day supply for 2 copays)1 | $30 |
| Non-preferred brand (30-day supply at medical center pharmacies, or up to 90-day supply for 2 copays)1 | $45 |
| Emergency care2 | $50 |
| Urgent care3 | $20 |
| Routine prenatal care, first postpartum visit | $0 |
| Inpatient delivery (per admission) | $0 |
| Outpatient surgery (per visit)4 | $20 |
| Inpatient hospital care (per admission)4 | $0 |
This is a summary of the features of the Kaiser Permanente health plan. For more information, read your Summary of Benefits and Coverage (SBC). All benefits are subject to the definitions, limitations, and exclusions set forth in the Evidence of Coverage (EOC).
1 Some medications are not eligible for Mail Order Pharmacy. Mail Order Pharmacy can deliver to addresses in MD, VA, D.C., and certain locations outside the service area. Plan providers determine the drug that is medically necessary. If you request another drug, you pay prices charged to members for non-covered drugs.
2 Per visit or trip as an outpatient at a hospital.
3 Per visit or trip as an outpatient at a hospital, when you receive care at a Kaiser Permanente facility. Out-of-network urgent care available when out of service area.
4 There is no charge after the office visit, outpatient, or inpatient hospital copayment is made.
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If you’re turning 65 soon, get the information you need with our Medicare 101, including enrollment, eligibility, costs, and the benefits of Medicare.
| Medicare-eligible retirees | Out-of-pocket costs |
| Primary care visit copay | $10 |
| Specialist visit | $10 |
| Preventive care | $0 |
| Most lab tests and X-rays | $0 |
| Imaging (CT/PET scans, MRI) | $0 |
|
For generic prescriptions: Mail order (up to a 100-day supply) Plan pharmacies (up to a 60-day supply) Participating retail pharmacies (up to a 60-day supply) |
$5 $10 $15 |
| Emergency care (per visit) | $50 |
| Urgent care (per visit) | $10 |
| Hospitalization, facility or surgeon | $0 |
| Video appointments with the doctor | $0 |
For more information, read your Summary of Benefits (SB). All benefits are subject to the definitions, limitations, and exclusions set forth in the Evidence of Coverage (EOC).
Kaiser Permanente is an HMO plan with a Medicare contract. Enrollment in Kaiser Permanente depends on contract renewal. You must reside in the Kaiser Permanente Medicare health plan service area in which you enroll.
If you’re ready to enroll and have Medicare Parts A and B, simply fill out the Group Medicare Enrollment form. There are two ways you can enroll:
Click here to find out the status of your Group Medicare enrollment.
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Kaiser Permanente is an HMO plan with a Medicare contract. Enrollment in Kaiser Permanente depends on contract renewal. You must reside in the Kaiser Permanente Medicare health plan service area in which you enroll.
* In the survey Best Health Insurance Companies of 2026 by Insure.com, Kaiser Permanente as a national enterprise is ranked #1 overall — for the sixth year in a row. In the NCQA Commercial Health Plan Ratings 2025, our commercial plan is rated 5 out of 5, the highest rating in Maryland, Virginia, and Washington, D.C. The Mid-Atlantic Permanente Medical Group is the largest multispecialty medical group in the Washington, D.C., and Baltimore areas and exclusively treats Kaiser Permanente members. Permanente doctors are recognized as Top Doctors in Arlington Magazine (2026), Northern Virginia Magazine (2026), Baltimore magazine (2025), Washingtonian magazine (2025), and Bethesda magazine (2025).
** When appropriate and available. If you travel out of state, phone appointments and video visits may not be available in select states due to licensing laws. Laws differ by state.
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Connect with a Kaiser Permanente advisor to learn more: 855-539-4197 (TTY 711), Monday through Friday, 10 a.m. to 9 p.m.