Health Plans & Support
Kaiser Medical Plans
Overview
If you live in Northern or Southern California, you may be able to choose Kaiser Permanente medical and prescription drug coverage. If available, you’ll see these options when you enroll.
You have 4 options:
For All Kaiser Permanente Plans:
You must use providers and facilities in the Kaiser Permanente network
There’s no out-of-area coverage, except for urgent care and emergencies
Preventive care is covered at 100%
Flu shots, routine physicals, blood pressure and cholesterol tests and cancer screenings
100%-Paid Preventive Care
Preventive care can help spot health problems before they become big issues. Our AEO medical plans cover in-network preventive care at 100%! Covered services include flu shots, routine physicals, well-woman exams, well-baby exams, blood pressure checks, cholesterol tests and cancer screenings.
How the Plans Work
$500 Plan
You pay copays for some services such as doctor’s office visits.
$2,000 HRA
AEO funds a Health Reimbursement Account that you can use to help pay for care. You pay copays for some services.
High HDHP and Low HDHP
AEO adds money to your Health Savings Account. You pay 100% of the cost for medical care and prescription drugs (except for certain in-network preventive care) until you meet your deductible.
$500 Plan and $2,000 HRA
For services such as hospitalization, you must meet your deductible before the plan shares costs. For the HRA plan, you can use your Health Reimbursement Account to help you pay for care.
High HDHP and Low HDHP
Once you meet your deductible, you’ll share costs with the plan until you meet the out-of-pocket maximum. You can continue using money from your Health Savings Account for your portion.
If you reach your out-of-pocket maximum, the plan will pay 100% of your eligible expenses for the rest of the plan year.
How Are the Plans Different?
Lowest
Highest
| $500 PLAN | $2,000 HRA | HIGH HDHP | LOW HDHP | |||
|---|---|---|---|---|---|---|
| Premiums (your monthly paycheck costs) | ||||||
| Deductible and out-of-pocket maximum | ||||||
| Money from AEO | None | Health Reimbursement Account | Health Savings Account | |||
| What you pay for care | Copays for some services and cost sharing (coinsurance) for other services | You pay 100% of the cost until you meet your deductible (except for certain in-network preventive care); after that, you and the plan share costs (coinsurance) | ||||
Save With Tax-Advantaged Accounts
All Kaiser Permanente medical plans offer ways to save with a tax-advantaged account.
DECODING DEDUCTIBLES AND
OUT-OF-POCKET MAXIMUMS
With all Kaiser Permanente plans, each family member has an individual deductible and out-of-pocket maximum. Each member must meet their own deductible or out-of-pocket maximum until expenses paid by all family members meet the overall family deductible or out-of-pocket maximum.
Kaiser Permanente Medical Plans at a Glance
Here’s a look at what you’ll pay when you need care. For more details, see the Summaries of Benefits and Coverage in the Documents section.
You will begin to contribute toward the plan deductibles and out-of-pocket limits from January 1 through December 31 each year.
| $500 PLAN | $2,000 HRA PLAN | HIGH HDHP | LOW HDHP | |||||
|---|---|---|---|---|---|---|---|---|
| IN-NETWORK ONLY | IN-NETWORK ONLY | IN-NETWORK ONLY | IN-NETWORK ONLY | |||||
| 2025 Contribution from AEO | ||||||||
| Individual2025 Contribution | None | $500 Health Reimbursement Account contribution | $500 Health Savings Account contribution | $250 Health Savings Account contribution | ||||
| Family2025 Contribution | None | $1,000 Health Reimbursement Account contribution | $1,000 Health Savings Account contribution | $500 Health Savings Account contribution | ||||
| You Pay | ||||||||
| Deductible (what you pay first for some services) | ||||||||
| IndividualDeductible | $500 | $2,000 | $1,650 | $3,300 | ||||
| FamilyDeductible | $1,000 | $4,000 | $3,300 | $6,600 | ||||
| Out-of-Pocket Maximum1 (the most you have to pay for eligible services) | ||||||||
| IndividualOut-of-pocket maximum | $3,000 | $4,000 | $3,300 | $5,250 | ||||
| FamilyOut-of-pocket maximum | $6,000 | $8,000 | $6,600 | $10,500 | ||||
| Preventive Care | ||||||||
| Well-adult visits, well-child visits and immunizationsPreventive Care | $0 | $0 | $0 | $0 | ||||
| Office Visits | ||||||||
| TelehealthOffice Visits | $0 | $0 | $0 after deductible | $0 after deductible | ||||
| Primary careOffice Visits | $20 | $20 | 10% after deductible | $30 after deductible | ||||
| SpecialistOffice Visits | $20 | $20 | 10% after deductible | $50 after deductible | ||||
| Labs and Imaging | ||||||||
| Diagnostic tests (X-rays, bloodwork) and imaging (CT/ PET scans, MRIs)Labs and Imaging | Diagnostic tests: $10 Imaging: 20% after deductible up to $150 per procedure | Diagnostic tests: $10 Imaging: 20% after deductible up to $150 per procedure | 10% after deductible | Diagnostic tests: $10 after deductible Imaging: 30% after deductible up to $150 per procedure | ||||
| Emergency Services | ||||||||
| AmbulanceEmergency Services | $150 per trip | $150 per trip | 10% after deductible | $100 per trip after deductible | ||||
| Emergency Room | 20% after deductible | 20% after deductible | 10% after deductible | 30% after deductible | ||||
| Urgent careEmergency Services | $20 | $20 | 10% after deductible | $30 after deductible | ||||
| Hospital | ||||||||
| Inpatient and outpatientHospital | 20% after deductible | 20% after deductible | 10% after deductible | 30% after deductible | ||||
| Maternity Care | ||||||||
| Office visits and childbirth/deliveryMaternity Care Pregnancy | Office visits: $02 Childbirth/delivery: 20% after deductible | Office visits: $02 Childbirth/delivery: 20% after deductible | Office visits: $02 Childbirth/delivery: 10% after deductible | Office visits: $02 Childbirth/delivery: 30% after deductible | ||||
| Mental Health/Substance Abuse | ||||||||
| Inpatient careMental Health Support Substance Abuse | 20% after deductible | 20% after deductible | 10% after deductible | 30% after deductible | ||||
| Outpatient careMental Health Support Substance Abuse | Individual visit: $20 Group visit: $10 for mental/behavioral health; $5 for substance abuse | Individual visit: $20 Group visit: $10 for mental/behavioral health; $5 for substance abuse | 10% after deductible | Individual visit: $30 after deductible Group visit: $15 after deductible for mental/behavioral health; $5 after deductible for substance abuse | ||||
- Out-of-pocket maximum includes deductibles, copays (if applicable) and coinsurance.
- Depending on the type of service, a copay, coinsurance or deductible may apply.
Costs for Coverage
Here are your biweekly paycheck costs for Kaiser Permanente medical coverage.
| COVERAGE TIER | KAISER PERMANENTE $500 PLAN | KAISER PERMANENTE $2,000 HRA PLAN | KAISER PERMANENTE HIGH HDHP | KAISER PERMANENTE LOW HDHP |
|---|---|---|---|---|
| Associate | $93.00 | $42.00 | $52.00 | $17.00 |
| Associate + 1 | $185.00 | $84.00 | $103.00 | $33.00 |
| Associate + Family | $278.00 | $123.00 | $152.00 | $49.00 |
Live Well
Check out these programs from Kaiser Permanente. Visit kp.org for details.
- Telehealth — Meet face-to-face with a doctor by video or phone from the comfort of home.
- Maternity care — Get help with family planning and fertility services, delivery and postpartum care. Plus, you can explore classes and programs.
- Health goals — Kaiser Permanente offers a number of tools and resources to help you with your health goals, including wellness coaching and smoking cessation.
Find A Provider
You might be interested in:
AEO Real Care Health Centers
Our AEO Real Care Health Centers can help you get the care you need fast — for $15 or less. You can use the centers even if you’re not enrolled in an AEO medical plan.
Learn More