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 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 covered8

Active employees and pre-65 retirees

A quick look at out-of-pocket costs

Active employees Pre-65 retirees
HMO Signature pharmacy1 HMO Signature no pharmacy HMO Signature pharmacy1
Primary care visit $10 $10 $10
Specialist visit $20 $20 $15
Preventive care No charge No charge No charge
Most lab tests and X-rays No charge No charge No charge
Most generic
(in-network/
community pharmacy1
 $10 / $15 Not covered $10 / $15
Most preferred brand
(in-network/
community pharmacy)1
 $15 / $20 Not covered $10 / $15
Non-preferred brand
(in-network/
community pharmacy)1
 $15 / $20 Not covered $10 / $15
Emergency care2 $150 $150 $100
Urgent care3 $20  $20 $15
Routine prenatal care, first postpartum visit No charge No charge No charge
Inpatient delivery (per admission) No charge No charge No charge
Outpatient surgery (per visit)4 $20 $20 $15
Inpatient hospital care (per admission)4 No charge No charge No charge
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 For plan with Rx: Up to a 60-day supply; Up to a 90-day supply for 1 copay. 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). 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.

Active employees plan details

We recommend you view on your laptop or desktop computer.

Effective 1/1/25 – 12/31/25

Effective 1/1/24 – 12/31/24

Pre-65 retirees plan details

We recommend you view on your laptop or desktop computer.

Effective 1/1/25 – 12/31/25

Effective 1/1/24 – 12/31/24

Other important documents

Kaiser Permanente Medicare Advantage (HMO) Plan

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 that 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

A quick look at out-of-pocket costs

Summary of benefits Out-of-pocket costs
Annual out-of-pocket maximum $3,400 per calendar year
Deductible None
Office visits (primary and specialist) $5 copay per visit
Lab/X-rays/CT scan/MRI/PET Covered in full
Outpatient surgery (per visit) Covered in full
Hospitalization services Covered in full
Emergency services $50 copay per visit
Ambulance services Covered in full
Urgent care $5 copay per visit
Eyewear $200 allowances every 24 months
Skilled nursing facility (limited to 100 days per benefit period Covered in full
Most generic (in-network/community pharmacy) $5 for up to a 60-day supply
Preferred brand (in-network/community pharmacy) $10 for up to 60-day supply
Specialty (in-network/community pharmacy)
$3 for up to a 90-day supply (mail order)

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.

Medicare-eligible retirees plan details

Medicare eligible retiree 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 1/1/25 – 12/31/25

Effective 1/1/24 – 12/31/24

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+ insurance carriers. In the NCQA Commercial Health Plan Ratings 2022, our commercial plan is rated 5 out of 5, the highest rating in the nation. 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 Northern Virginia Magazine (2023), Washingtonian magazine (2022), and Baltimore magazine (2022). According to NCQA’s Quality Compass® 2022, we’re rated 5 out of 5 in 29 measures, including: controlling blood pressure (heart disease), blood pressure control (140/90) (diabetes), glucose control, colorectal cancer screening, breast cancer screening, cervical cancer screening, childhood immunizations, prenatal check-ups, 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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