Kaiser Permanente Medical
You have three plan options to choose from through Kaiser Permanente. All plans include free preventive care and free preventive care medications.
Medical Plan Comparison – Kaiser Permanente
You have access to three medical plan options through Kaiser Permanente. Kaiser plans offer in-network coverage only, meaning there is no benefit for medical services provided by out-of-network providers.
|Plan Features||Kaiser Copay Plus||Kaiser Copay Basic||Kaiser HDHP (HSA Qualified)|
|Annual Deductible||$750 individual*
|Annual Company HSA Contribution||None||None||$720|
|Covered in full||Covered in full||Covered in full|
|$10 copay||$15 copay||25% after deductible|
|Specialist Visit||$25 copay||$35 copay||25% after deductible|
|Urgent Care||$75 copay||$75 copay||25% after deductible|
|$500 copay||20% after deductible||25% after deductible|
|Inpatient Services||20% after deductible||20% after deductible||25% after deductible|
|Prescription Drugs: Retail (up to a 30-day supply)|
|Generic||$10 copay||$10 copay||$10 copay after deductible|
|Brand Formulary||$30 copay||$30 copay||$30 copay after deductible|
|Non-Formulary||$60 copay||$60 copay||$60 copay after deductible|
|Specialty||20% up to
|20% up to
|20% after deductible
up to $120 copay
|Prescription Drugs: Mail Order (up to a 90-day supply)|
|Generic||$20 copay||$20 copay||$20 copay
|Brand Formulary||$60 copay||$60 copay||$60 copay
|Non-Formulary||$120 copay||$120 copay||$120 copay
|Specialty||20% up to
|20% up to
|Deductible, then 20% up to
*Deductible is embedded. Family members meet only their individual deductible and then their claims will be covered under the plan coinsurance; if the family deductible has been met prior to their individual deductible being met, their claims will be paid at the plan coinsurance.
**Deductible is aggregate. All family members contribute towards the family deductible. An individual cannot have claims covered under the plan coinsurance until the total family deductible has been satisfied.
***Out-of-pocket max is embedded. After each eligible family member meets his or her individual out-of-pocket maximum, the plan will pay 100% of their covered expenses. Or, after the family out-of-pocket maximum has been met, the plan will pay 100% of each eligible family member’s covered expenses.
****Out-of-pocket max is aggregate. If you have other family members in this plan, the overall family out-of-pocket limits must be met.
No-Cost Preventive Prescriptions
Both Cigna and Kaiser medical plans include preventive care medications at no out-of-pocket cost to you. You can use your Kaiser member ID card to get free preventive care medications providing that the medication is:
- Prescribed by a health care professional
- Age and condition appropriate
- Filled at an in-network pharmacy
Examples of covered medications include:
- Asprin, folic acid, and other select common over-the-counter medications
- Nicotine cessation medications
- Human immunodeficiency virus preventive medications
- Breast cancer preventive medications
- Statin preventive medications
- Birth control products
- Flu shots and other vaccines
Finding a Doctor
Kaiser Members: Visit https://my.kp.org/stateofcolorado, download the app, or call (888) 413-0591.