Kaiser Signature (Deductible) HMO Plan – California and Mid Atlantic

PARTNER | KAISER PERMANENTE

Signature (Deductible)HMO Plan - California and Mid Atlantic

Through the Signature (Deductible) HMO plan, you receive the quality care and service you expect from Kaiser Permanente. You will pay the full charges for some services until you reach your deductible. After you reach your deductible you’ll start paying less – a copay or a percentage of the charges (coinsurance) for the rest of the plan year.

Kaiser Signature (Deductible) HMO Plan - California and Mid Atlantic Network: Kaiser
Group/Policy #: Northern CA Region: 606131 Southern CA Region: 234268 Mid-Atlantic Region: 26847

*Plan Design Subject to the Deductible

  • Deductible | $1,000 Individual ($2,000 Family) The amount you owe for health care services before your health insurance or plan begins to pay.
  • Maximum Out of Pocket | $3,000 Individual ($6,000 Family) The money you pay for covered medical and pharmacy services counts toward your out of pocket maximum. Once you meet your designated out of pocket maximum, the plan will pay for all of your covered healthcare costs for the rest of the plan year.
  • Primary Care Doctor | $25 copay A PCP is the person your child should see for a routine checkup or non-emergency medical care
  • Specialist | $40 copay A physician specialist focuses on a specific area of medicine or a group of patients to diagnose, manage, prevent or treat a certain types of symptoms and conditions
  • Telemedicine | $0 copay Telemedicine refers to the practice of caring for patients remotely when the provider and patient are not physically present with each other. Modern technology has enabled doctors to consult patients by using HIPAA compliant video-conferencing tools.
  • Urgent Care | $25 copay Care for an illness, injury or condition serious enough that a reasonable person would seek care right away, but not so severe as to require emergency room care.
  • Hospital | 20% coinsurance* The portion of eligible expenses that plan members are responsible paying, most often after the deductible is met. It's usually determined as a percentage of the total cost.
  • X-Ray and Labs | 20% coinsurance* The portion of eligible expenses that plan members are responsible paying, most often after the deductible is met. It's usually determined as a percentage of the total cost.
  • Emergency Room | $150 copay* (after ded for CA plans) The Emergency Room (ER) provides care for these critical or life-threatening conditions and not for routine health care.

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