Individual & Family Health Insurance Plans
These are plans you can buy on your own (not through an employer). All offer quality care within Kaiser Permanente’s integrated medical system — doctors, specialists, hospitals, pharmacies, and labs — and are designed around different budgets and needs:
Metal Tier Plans
Kaiser offers plans in Bronze, Silver, Gold, and Platinum levels:
- Bronze – Lowest monthly cost but higher out-of-pocket costs for care.
- Silver – Medium premiums and medium expenses when you get care.
- Gold – Higher premiums, lower costs when you use services.
- Platinum – Highest premium, lowest cost share for care.
You get the same quality care in all plans; the difference is how costs are split between you and the plan.
Types of Coverage Styles
Kaiser offers different plan structures within Individual & Family plans:
- Copay Plans – No deductible; simple, predictable copays for care.
- Deductible Plans – Lower premium but you pay more before insurance kicks in.
- Virtual Plans – Lower costs if you use telehealth (online/virtual visits).
- HSA-Qualified Plans – Works with a Health Savings Account (HSA) for tax-free health spending.
- Catastrophic Plans – High deductible and low premium plans intended mostly for people under 30 or with special exemptions; mainly help if major health events occur.
2. Employer-Sponsored & Group Plans
If you get insurance through your job, Kaiser offers group plans that may include:
- Traditional HMO Plans – Integrated care with predictable costs.
- KP Plus Plans – Members can see in-network Kaiser doctors and a limited number of out-of-network providers each year.
- Everyday Care Plans – Essential covered services without complex cost sharing.
- Group Medicare Plans – For workforce retirees eligible for Medicare, combining Kaiser coverage with Medicare benefits.
Plans vary by employer size and region, and employers often subsidize part of the premium.
3. Medicare & Medicaid Plans
Medicare Advantage Plans
Kaiser offers Medicare Advantage (Part C) plans that bundle Medicare Parts A (hospital), B (medical), and often Part D (prescription drugs) — and sometimes extra benefits like vision or fitness programs. These plans are available in certain regions and generally include coordinated care through the Kaiser network.
Medicaid Plans
In some states, Kaiser offers Medicaid (including state programs like Medi-Cal) plans that provide $0 or low-cost care for qualifying low-income individuals and families.
4. Other Coverage Features
Preventive care at low or no cost (e.g., checkups, screenings).
Virtual care options like telehealth visits included in many plans.
Plans vary by state and region, and not all types may be offered everywhere.
Open Enrollment — you can typically enroll or change plans once a year unless you have a qualifying life event (like marriage, birth of a child, job change).
How Kaiser Permanente Plans Work
Kaiser’s plans emphasize coordinated care — your primary care doctor and specialists work together in the same system to manage your health. Most plans require you to get care from Kaiser Permanente providers and facilities (especially HMO plans), though some group plans offer limited out-of-network access.
Costs you’ll consider include:
- Monthly premium — what you pay each month to keep coverage.
- Deductible — what you pay before insurance begins to share costs.
- Copays & coinsurance — your share when you get services.
- Out-of-pocket maximum — the most you’ll pay in a year before full coverage begins.
In Summary
| Plan Type | Best For |
|---|---|
| Individual/Family (Bronze-Platinum) | Personal coverage between open enrollments |
| HSA-Qualified | Tax-advantaged savings for medical costs |
| Virtual Plan | Affordable telehealth focus |
| Employer/Group Plans | Job-based coverage with potential subsidies |
| Medicare Advantage | Seniors on Medicare |
| Medicaid | Low-income eligible individuals/families |
| (Coverage levels, availability, and costs vary by location and year.) |
