Kaiser Permanente

If you elect to participate in the Kaiser Permanente HMO plan, you are limited to using physicians and facilities that are part of Kaiser Permanente’s network of providers. All health care services (except for emergencies) must be coordinated and approved by your primary care physician (PCP).

Here are some of the features of the Kaiser Permanente HMO Plan. For more information, refer to the 2023 Faculty & Staff Medical Plan Coverage Comparison Chart or 2023 LIUNA BU Medical Plan Coverage Comparison Chart and the Summary Plan Description (SPD).

 

Plan Benefits You Pay…
Annual Deductible $0
Physician Services (office visits) $20 copay; $35 specialist copay
Physician Services (inpatient) $0
Preventive care (physical exams and well baby) $0
Emergency care $100 copay (waived if admitted)
Urgent care $50
Hospital copay per inpatient admission $250
Hospital service benefits $0 after $250 hospital copay
Outpatient surgery $100 copay
Vision Care $10 optometrist copay; $20 ophthalmologist copay

Discounted lenses, frames, and contacts

Plan Year Maximums
Annual Maximum Benefit None
Annual Out-of-Pocket Maximum $3,500 per person
$9,400 per 3 or more persons