A quick look at your plans
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.
HMO Plus with Signature
Our HMO Plus plan is easy on your budget with 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* — but you’re also covered for up to 10 out-of-network services per year for certain physician, laboratory, and radiology services, as well as up to 5 pharmacy refills per year with any out-of-network provider in the US. This means you can keep your favorite doctor outside of our network and still have access to our quality care.
You’ll receive our care in state-of-the-art medical centers, where you can access many services under one roof, saving you time and hassle. Certain specialties like obstetrics-gynecology (ob-gyn), pediatrics, and mental health services don’t require a referral. You also have access to urgent care and emergency care nationwide, so you’re always covered.
Actives and early retirees
A quick look at out-of-pocket costs
| Actives and early retirees | In-Network | Out-of-Network1 |
| Primary care visit | $10 | $30 |
| Specialist visit | $20 | $40 |
| Preventive care | $0 | $0 |
| Most lab tests and X-rays | $0 | $20 |
| Most generic (in-network/community pharmacy)2 | $7 / $20 | $25 |
| Most preferred brands (in-network/community pharmacy)2 | $15 / $35 | $45 |
| Non-preferred brand (in-network/community pharmacy)2 | $30 / $50 | $70 |
| Emergency care | $150 | $150 |
| Urgent care4 | $20 | $20 |
| Routine prenatal care, first postpartum visit | $0 | Covered in-network |
| Inpatient delivery (per admission) | $0 | Covered in-network |
| Outpatient surgery (per visit)5 | $20 | Covered in-network |
| Inpatient hospital care (per admission)5 | $0 | Covered in-network |
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 and early retirees plan details
We recommend you view on your laptop or desktop computer.
Effective 1/1/23 – 12/31/23
Other important documents
Medicare Advantage
Get care designed to make your life easier — choose a Kaiser Permanente Medicare Advantage plan. With Kaiser Permanente, your doctor, specialists, and health plan all work together to make it easier for you to get care. And when you move your coverage to a Kaiser Permanente Medicare Advantage plan, you’ll get comprehensive care — at a great value.
You can count on:
- Predictable costs and a fixed annual limit on your out-of-pocket costs
- High-quality care from a doctor and care team who get to know you
- The freedom to change to another available Kaiser Permanente doctor anytime
- Convenient care options to make it easier to stay healthy
Medicare-eligible retirees enrolled in Kaiser Permanente Medicare Advantage (HMO)
A quick look at out-of-pocket costs
| Medicare-eligible retirees | Out-of-pocket costs |
| Primary care visit copay (waived for children through age 5) | $10 |
| Specialist visit | $10 |
| Preventive care | $0 |
| Most lab tests and X-rays | $0 |
| Imaging (CT/PET scans, MRI) | $0 |
|
Per prescription:1 Mail order (up to a 90-day supply) Plan pharmacies (up to a 60-day supply) Participating retail pharmacies (up to a 60-day supply) |
$3 $5 $10 |
| Emergency care2 | $50 |
| Urgent care3 | $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.
1 For certain drugs, you can get prescription refills mailed to you through our Kaiser Permanente Mail Order Pharmacy. You should receive them within 3–5 days. If not, please call 800-700-1479 (TTY 711), 24 hours a day, 7 days a week. Some medications are not eligible for Mail Order Pharmacy. Mail Order Pharmacy can deliver to addresses in MD, VA, DC, and certain locations outside the service area.
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.
Medicare-eligible retirees plan details
We recommend you view on your laptop or desktop computer.
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.
Effective 1/1/24 – 12/31/24
Effective 1/1/23 – 12/31/23
Other important documents
- Added features brochure
- Medicare Advantage handbook (coming soon)
- Medicare on-the-go brochure
- Medical center guide
- Silver&Fit brochure
- Thriving After 60 schedule
* In the survey Best Health Insurance Companies of 2026 by Insure.com, Kaiser Permanente as a national enterprise is ranked #1 overall. 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, DC. 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 Northern Virginia Magazine (2026), Baltimore magazine (2025), Washingtonian magazine (2025), Arlington Magazine (2025), and Bethesda magazine (2025). In the HEDIS® 2024 report, we’re the top performer in 44 care measures — more than any other health care organization in the nation.
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.