Your Copay Plan with Kaiser Permanente is not just health coverage — it's a partnership in health. You receive preventive care services at little or no cost to you, and online features let you manage most of your care around the clock. Silicon integrated usb devices driver download. Your benefits include: a personal doctor for routine health care. Kaiser Permanente’s state-of-the-art medical offices are located throughout the region, with doctors, specialists, imaging, pharmacy and many times, labs, all in one place. You are covered for emergency care worldwide. The emergency care copay will be waived if you are directly admitted to a hospital as a result of an emergency. Kaiser Permanente 2020 Sample Fee List. Then you’ll start paying less — a copay or a percentage of the charges (a coinsurance) for the rest of the year. Depending on your plan, you may pay copays or coinsurance for some services without having to reach your deductible. After that, we’ll no longer be able to make changes or cancel your prescription. If you have additional questions, contact us: Send a text to 452-80, and we'll respond within one business day. Call us at 1-800-245-7979 (TTY 711), Monday through Friday, 7:30 a.m. Copayment or coinsurance may apply. For example, this plan covers certain preventive services without cost sharing and before you meet your. With a prescription when filled at a Kaiser Permanente pharmacy. For Southern Colorado members: Prescriptions for second fill and on.
All Kaiser Permanente health plans cover the medical benefits you and your family need, with an emphasis on preventive care and your overall wellness. Plus, every plan includes access to high-quality virtual care with Kaiser Permanente doctors and clinicians. Choose from online chat, video, phone, and more1 to get the care and prescriptions you need or help finding in-person care.
Our plans offer you a wide range of choices in monthly premiums and cost shares, such as copays and coinsurance, to fit your budget and your needs. Learn more about the benefits of each plan.
Once you’ve browsed plan rates, benefits, and evidence of coverage documents (linked below), get a quote and enroll directly through Kaiser Permanente.
If you qualify for financial help with your cost of coverage (use our tool to find out), then you'll need to enroll through the exchange, Washington Healthplanfinder.
More resources
2021 enrollment guide & rates (PDF)
2021 WA Healthplanfinder enrollment guide (PDF)
Summary of benefits and coverage
Enrollment application (PDF)
Dental coverage
Account change form (PDF)
Tobacco affidavit (PDF)
Affordable Care Act
Evidence of coverage
Most Kaiser Permanente plans require members to make copayments directly to the provider. Copayments for office visits, pharmacy services, emergency room care, and inpatient hospital care can be found online if you are registered through One Health Port to access Kaiser Permanente.
For members on Medicare hospice plans or contracts, copayment applies to non-hospice services only.
You should collect copayments from our members at the time service is provided. You may charge interest, a reasonable billing fee, or both on unpaid copayments as stated in your office policy. The exceptions are Medicare and Medicaid enrollees, for whom it is against federal regulation to collect such fees.
Never collect a copayment from approved Medicaid enrollees; it is against federal regulation to collect such fees.
You should collect copayments for office visits only when the member sees a physician, physician's assistant, or nurse practitioner. There is no copay for seeing a lab technician.
Some group plans cover preventive care visits in full. If a member is on such a plan, do not collect a copayment.
Kaiser Permanente Copay Rates
Outpatient services requiring copayments
- Audiology/hearing tests
- Family planning, prenatal, post-partum visits, and prenatal tests (but not if the provider bills globally)
- Injectable medications that may be self-administered at home
- Office visits and consultations
- Pharmacy services
- Physical, occupational, and speech therapies
- Radiation therapy and chemotherapy (except PEBB)
- Emergency room visits where there is no hospital admission
- Most mental health and substance use disorder visits
Outpatient services generally not requiring copayments
- Diagnostic radiology, ultrasound, and lab services. Exception: High-end radiology may have a copayment.
- Echocardiograms
- EEG and EKG cardiac tests
- Preventive care visits, depending on the group plan
- Injections and immunizations except injectable medications that may be self-administered at home
- Nursing home services
- Pulmonary function tests
- Tympanometry
- Visiting nurse services
- Psychological tests
- Methadone treatment
Kaiser Permanente Copay Restasis Xiidra
Contact the Provider Assistance Unit (PAU) with questions about copayments.
Content on this page is from the provider manual | Disclaimer
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