A quick look at your plans

Your health care plan with Kaiser Permanente is more than just coverage — it’s a partnership in health. It connects you to a group of physicians, services, and tools that can help you live your best life. Plus, you get most preventive care services at little to no cost.

HMO with Signature

Our HMO plan is easy on your budget with no deductible and low, predictable costs for care. With Signature, you get high-quality care from 1,800+ Permanente physicians and specialists within the region’s leading health system.* They practice at our innovative, state-of-the-art medical centers, where you can access many services under one roof, saving you time and hassle. You can also save yourself trips with $0 telehealth care from the comfort of home.**

You can get many types of specialty care without a referral, including obstetrics-gynecology (ob-gyn), pediatrics, and mental health services. You also have access to urgent care and emergency care nationwide, so you’re always covered.

Actives/early retirees under 65

A quick look at out-of-pocket costs

Actives/early retirees under 65 In-Network Out-of-Network1
Primary care visit $25 Not covered
Specialist visit $40 Not covered
Preventive care No charge Not covered
Most lab tests and X-rays No charge Not covered
Most generic (in-network/community pharmacy)2 $15 Not covered
Preferred brand (in-network/community pharmacy)2 $25 Not covered
Non-preferred brand (in-network/community pharmacy)2 $40 Not covered
Emergency care3 $75 $75
Urgent care4 $40 $40
Routine prenatal care, first postpartum visit No charge Not covered
Inpatient delivery (per admission) No charge Not covered
Outpatient surgery (per visit)5 $75 Not covered
Inpatient hospital care (per admission)5 $300 Not covered

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 This plan covers up to 10 out-of-network medical visits for certain physician, laboratory, and radiology services, and 5 pharmacy refills per year with any licensed provider outside of the Kaiser Permanente care delivery system, anywhere in the United States. 

2 Certain medications are eligible for Mail Order Pharmacy. Mail Order Pharmacy can deliver to addresses in MD, VA, DC, 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. For more information about prescription drugs and other common medical events, including exclusions and limitations, read your Summary of Benefits and Coverage (SBC). 

3 Per visit or trip as an outpatient at a hospital.

4 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.

5 There is no charge after the office visit, outpatient, or inpatient hospital copayment is made.

Actives/early retirees under 65 plan details

We recommend you view on your laptop or desktop computer.

Effective 7/1/24 – 6/30/25

Effective 7/1/23 – 6/30/24

New dental administrator

On January 1, 2024, Kaiser Permanente changed its dental plan administrator from Dominion National (Dominion) to LIBERTY Dental Plan (LIBERTY). Kaiser Permanente members with dental coverage were automatically transitioned from Dominion to LIBERTY with no changes to their dental benefits. Members received a welcome package with a description of their dental plan benefits and a new dental ID card. For additional information about LIBERTY and your dental benefits, please visit libertydentalplan.com/kp-cova.

Other important documents

* In the survey Best Health Insurance Companies of 2023 by Insure.com, Kaiser Permanente as a national enterprise is rated #1 overall among 60+ competitors. In the NCQA Commercial Health Plan Ratings 2023, our commercial plan is rated 5 out of 5, the highest rating in the region. The 2022 Commission on Cancer, a program of the American College of Surgeons, granted Three-Year Accreditation with Commendation to the Kaiser Permanente cancer care program. The Mid-Atlantic Permanente Medical Group is the largest multispecialty medical group in the Washington, DC, and Baltimore areas and exclusively treats Kaiser Permanente members. Permanente doctors are recognized as Top Doctors in Arlington Magazine (2023), Baltimore magazine (2023), Bethesda magazine (2023), Northern Virginia Magazine (2023), and Washingtonian magazine (2023). According to NCQA’s Quality Compass® 2023, we’re rated 5 out of 5 in 31 measures, including: controlling high blood pressure, glucose control and blood pressure control (140/90) for diabetes, breast cancer screening, colorectal cancer screening, childhood and adolescent immunizations, and postpartum care. Quality Compass is a registered trademark of the NCQA. ** 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.

Easy to Join

Find out how convenient it is to switch.

Connect with a Kaiser Permanente advisor to learn more: 800-324-9208 (TTY 711), Monday through Friday, 10 a.m. to 9 p.m.

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