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Kaiser Permanente California Individual Health Insurance
With so many health insurance companies and plans to choose from, the task of finding the right health care coverage for yourself or your family can sometimes be a daunting experience. This page is designed to simplify the insurance jargon so you can determine the best medical insurance plan for you or your family and feel good about your choice. You don’t have to take a shot in the dark and hope you made a wise selection; you can choose with confidence. Use the form on the left to get personalized quotes. Simply enter your zip code and click “Go”. Use the links below to apply or to view available Kaiser Permanente plans for individuals in California.
Apply Online (Or, click Print Application and apply via fax or mail.)
Why Choose Kaiser Permanente?
Kaiser Permanente leads the health care industry in innovation and medical advancement while keeping in mind the diverse needs and lifestyles of Americans. For this reason, they make available a wide array of affordable California individual medical insurance offerings which let you tailor the benefits to your particular health care and financial needs. Essentially, the variety of medical coverage offered allows you to choose how much you want to pay for monthly premiums versus how much you pay for care at the point-of-service.
Coverage Benefits
Get the right coverage at the right price. There are certain medical benefits you want for you and for your family. Kaiser Permanente plans include the following benefits:
- Primary Care
- Specialty Care
- Outpatient Surgery
- Maternity*
- Emergency
- Ambulance
- Hospitalization
- Labs and X-rays
- Prescription Drugs*
- Chemical Dependency
- Mental Health
- Preventive Physical Exams
Note: Some policies require you to pay full price for these benefits before you have reached your deductible. Some do not include benefits with an asterisk (*). Most preventive care including Annual Physicals is covered at no charge before the deductible is reached.
14 Different Plans
Explore the fourteen California individual medical insurance plans offered by Kaiser Permanente and choose the right coverage for you. There are three basic types of plans: Copayment, Deductible and HDHP Deductible Plans with HSA.
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3 Copayment Plans: Predictability and Convenience for Maximum Peace of Mind
The Kaiser Permanente Copayment Plans give you the broadest coverage on a non-deductible basis. Since there are no deductibles, you pay the lowest fees, or copayments, when you go in for a visit. The only drawback with them is that the monthly premiums tend to be pricey. Despite the higher cost, many find that the predictability and convenience of low copayments make it worth the price. The most popular of the Kaiser Permanente Copayment Policies is the $25 Copayment Plan. The most affordable is the $50 Copayment (without prescription benefits).
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6 Standard Deductible Plans: An Affordable Middle-of-the Road Option
The best-selling of the Kaiser California individual health insurance plans are the standard HMO Deductible Policies. The beauty of this coverage is that it gives you affordable premiums and often immediate coverage for doctor visits and prescriptions with a low copayment. This means you get the best of both worlds: coverage for the type of services that are most commonly needed and a reasonably-priced premium. Additionally, preventive services are free! These plans are suitable for people who are reasonably healthy. In most cases they allow you to see a doctor or receive prescriptions immediately with a low copayment, and all other services are subject to the deductible. The most popular are the $30/$1,500, $40/$2,000, and $40/$3,000. The deductibles are stair-stepped to help you adjust your premium. The $50/$5,000 is the most economically-priced, but be aware that with this plan, office visits are subject to the deductible and prescription drugs are not covered.
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5 Health Savings Accounts (HSA’s): For Major Medical Needs & Tax Deductions
Health Savings Account (HSA) Policies are high deductible health plans designed for people who mostly want catastrophic coverage. With the exception of preventive exams, all services are subject to the deductible. If you don’t need bells and whistles, consider these policies to lower your premium. The HSA individual policies are a viable option for people with relatively good health and who are comfortable with a high deductible health plan just in case a major medical situation comes up. These private policies are government-qualified so that members have the option to open a health savings account at Wells Fargo Bank or their preferred financial institution. The $0/$1,500 HSA Plan is a good choice for people who are looking for low out-of-pockets for an anticipated procedure, such as pregnancy delivery. The $0/$5,000 HSA is a popular choice for those who want an inexpensive premium and a reasonable maximum out-of-pocket.
All Must Apply Separately
Kaiser Permanente California private health insurance coverage is no longer offered on a family basis. Families can still be covered, but individual medical insurance plans are issued separately. Each applicant will be evaluated and either approved or denied on an individual basis. You can no longer get family plans that have combined family deductibles and out-of-pocket maximums. All family members can be insured provided they meet the underwriting guidelines.
If you are shopping for multiple family members, remember that not everyone has to be on the same policy type. In some cases it may make sense to choose different plans for different family members. This is especially true if someone in your family is planning on getting pregnant. In this situation, you may want to put the female who is planning on having a baby on a richer plan. For information on insuring children, click California Child Health Insurance.
Switching Plans
Follow the directions below to switch plans:
New Members (first 30 days): When you are newly enrolled on a Kaiser individual plan, you have 30 days after your effective date in which you can switch plans. Fax Kaiser Permanente Member Services a letter stating your intention to switch plans and what plan you want to switch to. For Northern California, fax to (858) 614-3344. For Southern California, fax to (858) 614-3345. The letter needs to be signed by the plan member. Also, include your name (signature and printed out), date of birth, address and phone number. If the member is a child, please include the parent/guardian’s name (signature and printed out) and the parent/guardian’s date of birth. Existing Members (Beyond 30 days): If you have been enrolled on a Kaiser Permanente individual plan for more than 30 days and you wish to downgrade coverage or get a less expensive plan, contact Kaiser Member Services at 1-800-464-4000. If you are looking to upgrade to a plan with increased benefits, you will need to re-apply and your application will have to be approved by underwriting.
Note: For the Disclosure Form for Kaiser Permanente Individuals and Families, click here. For more information about KPAOL, the online application, click Kaiser Permanente Apply Online system.
