2101 East Jefferson Street, Rockville, MD 20852, Notice of Nondiscrimination and Other Languages, Find care options and Urgent Care locations near you, Your user name and password can also be used on our mobile app. For most plans, the outpatient surgery benefit will be billed at a lower cost if performed at an ambulatory surgical center vs. the outpatient department of a hospital. If you have any questions, please contact Customer Service at 855.733.7524. Deductible HMO (DHMO) Plan. Kaiser Permanente: HSA-QUALIFIED DEDUCTIBLE HMO Coverage Period: 06/01/2015-05/31/2016 Summary of Benefits and Coverage: What this plan covers and what it costs. KAISER PERMANENTE $30/$1,500 DEDUCTIBLE HMO PLAN Small Business 61123410 January 2020 ADA FEATURES MEMBER PAYS CALENDAR-YEAR DEDUCTIBLE1 Individual/Family $1,500/$3,000 PHARMACY CALENDAR-YEAR DEDUCTIBLE N/A ANNUAL OUT-OF-POCKET MAXIMUM1,2 Individual/Family $3,500/$7,000 IN THE MEDICAL OFFICE Office visits3 Preventive exams3 … DHMO PLUS 250/20 KP CO Platinum POS 0/25 Product type HMO DHMO DHMO PLUS Point of Service In-network Point of Service Out-of-network Deductible Individual/Family $0 $400/$800 $250/$500 $0 $2,000/$4,000 Out-of-pocket maximum Individual/Family $3,000/$6,000 $4,000/$8,000 $4,000/$8,000 $3,500/$7,000 $8,750/$17,500 Coinsurance (member's cost) 10% 15% 15% In-network 25% Out-of … 1. care from over As you get familiar with the basic health plan types, you’ll have a better idea of what makes the most sense for your company. EO C #12 - Kaiser Permanente Deductible HMO Plan Evidence of Coverage for SAMPLE GROUP AGREEMENT . network gives you high-quality. NOTE: Information about the cost of this plan (called the premium) will be provided separately. Employer & Broker Support. EOC. Summary of Benefits and Coverage: What this plan covers and what it costs. The Kaiser Permanente Deductible HMO Plus plan with the Signature SM. (2) your medical condition or symptom. Si desea que el inglés sea su preferencia permanente de idioma en este sitio, vaya a su información personal de perfil. 1. care from over 1,500 physicians of the Mid-Atlantic Permanente Medical Group, P.C. The Accumulation Period for this plan is 1/1/18 through 12/31/18 (calendar year). Kaiser DHMO Kaiser HDHP (HSA Eligible) In-Network Out-of-Network In-Network Out-of-Network In-Network Only In-Network Only Type Of Plan Health Maintenance Organization Health Maintenance Organization Out-Of-Network Coverage N/A Yes Limited to Reasonable and Customary N/A Yes Limited to Reasonable and Customary Only For Emergency Care Limited to Reasonable and Customary Only For … Customer ID 116461 - DHMO XP Member Services 1-800-464-4000 Home Region: Southern California Principal benefits for Kaiser Permanente Deductible HMO Plan (1/1/20—12/31/20) Accumulation Period The Accumulation Period for this plan is January 1 through December 31. EOC. First Health Network 1-800-226-5116. Medical care is provided through Kaiser facilities and providers. Choose from telehealth options that fit into your schedule. Coverage Period: Beginning on or after 01/01/2016. Vision plans are underwritten by Avalon Insurance Company, and administered by DDSUSA, in DC, DE, MD, PA and VA. Last Modified on May 7, 2021. There are two options to choose from with your plan: Kaiser Permanente Signature (or in-network) and any other licensed provider (or out-of-network). … Advantages of Your Health Plan Deductible HMO Plan — Preventive Care Services and Doctor’s Office Visits With this Kaiser Permanente health plan, you get a wide range of care and support to help you stay healthy and get the most out of life. Kaiser Foundation Health Plan, Inc. Northern California Region . While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. Kaiser Foundation Health Plan of Washington's (formerly named Group Health Cooperative) commercial HMO rated the top health plan in the United States in the 2016 eValue8™ survey. Number: 350 . Kaiser DHMO Summary Plan Description; Kaiser Permanente - Kaiser HDHP with HSA . The full-time employee will pay for the difference when the selected plan’s premium exceeds the composite rate. Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2019 - 12/31/2019 : City and County of Denver DHMO 500 Coverage for: Individual/Family | Plan Type: HMO 1 of 6 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Click here to log in to our secure member portal to find a dentist that accepts your plan, view and print plan documents, view claims information (including EOB’s), determine the cost of your next visit to the dentist with Dominion’s Cost Calculator, change dentists and update your contact information.. With your Kaiser Permanente HMO plan, you get a wide range of care and support to help you stay healthy and get the most out of life. **Video visits are available for members who receive care at Kaiser Permanente medical centers. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at . Kaiser Permanente HMO. Kaiser Foundation Health Plan, Inc. Southern California Region A nonprofit corporation EOC #1 - Kaiser Permanente Deductible HMO Plan Evidence of Coverage for LEIDOS Group ID: 104359 Contract: 1 Version: 58 EOC Number: 1 January 1, 2018, through December 31, 2018 About this plan With the Deductible HMO Plan, you must first pay a predetermined Kaiser Foundation Health Plan of Washington's (formerly named Group Health Cooperative) commercial HMO rated the top health plan in the United States in the 2016 eValue8™ survey. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan The Kaiser Permanente Deductible HMO Plan with the Select sm network gives you quality care from over 1,500 physicians of the Mid-Atlantic Permanente Medical Group, P.C. Kaiser Foundation Health Plan, Inc. Northern California Region A nonprofit corporation EOC #13 - Kaiser Permanente Deductible HMO Plan Evidence of Coverage for AVAYA Group ID: 39425 Contract: 1 Version: 69 EOC Number: 13 January 1, 2020, through December 31, 2020 You already have access to the best of Kaiser Permanente through your traditional HMO or DHMO coverage—but as an HMO or DHMO Plus member, you get even more. planThe Summary of Benefits and Coverage (SBC) document will help you choose a health . Comparison - Medical Plan Summaries. ***These features are available when you get care at Kaiser Permanente facilities. Chat with a Kaiser Permanente doctor, email, or schedule a phone or video visit. EOC #350 - Kaiser Permanente Deductible HMO Plan Evidence of Coverage for . *National Committee for Quality Assurance “NCQA’s Private Health Insurance Plan Ratings 2017–2018.”. Kaiser Permanente: DEDUCTIBLE PLAN Coverage Period: 01/01/2017-12/31/2017 Summary of Benefits and Coverage: What this plan covers and what it costs. Group #:602484-0006. Usted ha elegido ver nuestro sitio web en español. For example, if you see your out-of-network provider and he/she orders a lab test done in his/her office, this will count as two visits. No Charge, no deductible. No coverage outside the service area other than urgent or emergency care. Preventive services on this plan are available at no cost share. Coinsurance is . That includes routine physicals, well-child visits, and certain screenings and tests (such as mammograms). SISC - SELF-INSURED SCHOOLS OF CALIFORNIA NCR . Deductible & Coinsurance may apply. You receive preventive care services at little or no cost to you, and online features let you manage most of your care around the clock. The Hospital Services DHMO plan provides a 17% savings compared to the current Kaiser Permanente $10 Copay Plan. Kaiser Foundation Health Plan, California Region . Al hacer clic en "Continuar", el sitio web se traducirá al español hasta que usted cierre esta sesión. The SBC shows you how you and the plan would share the cost for covered health care services. Kaiser Foundation Health Plan, Inc. Northern California Region A nonprofit corporation EOC #39 - Kaiser Permanente Deductible HMO Plan Evidence of Coverage for STATE CENTER COMMUNITY COLLEGE Group ID: 21594 Contract: 1 Version: 72 EOC Number: 39 October 1, 2018, through September 30, 2019 Member Service Contact Center 24 hours a day, seven days a week (except closed holidays) 1-800-464 … Kaiser Permanente Deductible HMO Plan (9/1/20—12/31/21) Accumulation Period The Accumulation Period for this plan is January 1 through December 31. Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2019 - 12/31/2019 : City and County of Denver DHMO 500 Coverage for: Individual/Family | Plan Type: HMO 1 of 6 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Number: 350 . No benefits, other than emergency care, are available out-of-network. Kaiser DHMO 500 Plan Summary. Other types of health plans. Think higher cost with greater flexibility. A great plan for good health With your Kaiser Permanente HMO plan, you get a wide range of care and support to help you stay healthy and get the most out of life. 39999.119.2.S000587142 - DHMO 7587 NCR Actives (continues) 21594 STATE CENTER COMMUNITY COLLEGE . The plan has a $500/$1,500 individual/family deductible. To find out more about what is covered under the Kaiser Permanente Network, see your Evidence of Coverage (EOC) or call Customer Service at: This site provides an overview of your benefits and services. Dental plans are underwritten by Dominion Dental Services, Inc. (DDSI). You must receive all of your care through an integrated system of participating physicians, hospitals and healthcare providers. Office Visits and Professional Services. 1 of 8 Copayments are fixed dollar amounts (for example, $15) you pay for covered health care, usually when you receive the service. PPO dental insurance plans, on the other hand, offer a balance between low-cost care and dentist choice. A nonprofit corporation. Your out-of-network benefit is not subject to a deductible, and it does not apply to your out-of-pocket maximum. With your plan, you pay $0 for preventive care. The District contribution is $100 per month for full time employees and $50 per month for part time employees. A PPO plan is also generally more expensive than an HMO plan. Check with your doctor’s office to find out if video visits are available to you. NOTE: Information about the cost of this plan (called the premium) will be provided separately. Out-of-network lab tests, X-rays, allergy injections, and physical, occupational, and speech therapy visits all count as separate visits. If there are any differences between this website and your Evidence of Coverage (EOC), your Evidence of Coverage (EOC) will prevail. your. Consider having prescriptions, labs and radiology performed at Kaiser Permanente to save on visit limits and out-of-pocket costs. A DHMO plan will provide discounted (and sometimes free) dental services to plan participants if you receive the services from a dentist inside the DHMO network. Sin embargo, algunas páginas y funciones solo aparecen en inglés. Kaiser DHMO $500 Plan: This plan uses the Kaiser network of physicians. Most doctor office visits, radiology services, lab tests, and prescriptions are available for a copay or coinsurance amount, even before you have reached the calendar year deductible. Out-of-Pocket Maximum(s) and Deductible(s) For Services that apply to the Plan Out-of-Pocket Maximum, you will not pay any more Cost Share for the rest of the Accumulation Deductible HMO Plan With your Kaiser Permanente health plan, you receive a wide range of care and support to help you stay healthy and get the most out of life. Home > Kaiser – Difference Between Plans. allowed amount for the service. Out-of-Pocket Maximum(s) and Deductible(s) For Services that apply to the Plan Out-of-Pocket Maximum, you will not pay any more Cost Share for the rest of the Accumulation Period once you have reached the amounts listed below. Preventive Care Adult Routine Care. You must be 18 or older to schedule a video visit. You will also be assigned an in-network primary care physician for your convenience, but you can change doctors any time. For more information about your coverage, or to get a copy of the complete terms of … In case of discrepancy between this site and the actual plan documents, the actual plan documents will prevail. 2021 HSA Contribution Limits: Single $3,600; Family $7,200; Employees age 55 or older are allowed a catch-up contribution up to an additional $1,000 annually. Principal Benefits for Kaiser Permanente Deductible HMO Plan (10/1/20—9/30/21) Accumulation Period The Accumulation Period for this plan is January 1 through December 31. Comments (-1) Kaiser HSA HMO Plan Summary . While all health plans offer basic preventive care, it’s important to understand the key differences. Deductible & Coinsurance may apply. A nonprofit corporation. If you have any questions, please contact Customer Service at 855.733.7524. Kaiser Foundation Health Plan, California Region . This is the fifth consecutive year our HMO product has been the top-ranked health plan in Georgia in U.S. News/NCQA America’s Best Health Plans annual compilation.1 Excellent Ratings from NCQA (Permanente), and thousands of community physicians in private practice. Member Service Contact Center 24 hours a day, seven days a week (except closed holidays) 1 … Plan type: DHMO Kaiser Permanente: HSA-QUALIFIED DEDUCTIBLE HMO Coverage Period: 06/01/2015-05/31/2016 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual+Family | Plan Type: DHMO This is only a summary. For more on Kaiser Permanente locations and services available. 2021-22 Information. Estamos trabajando para que más funciones estén disponibles en español. Out-of-Pocket Maximum(s) and Deductible(s) For Services that apply to the Plan Out-of-Pocket Maximum, you will not pay any more Cost Share for the rest of the Accumulation Period once you have reached the amounts listed below. Dominion Dental Services USA, Inc. (DDSUSA) is a licensed administrator of dental and vision benefits. This is the fifth consecutive year our HMO product has been the top-ranked health plan in Georgia in U.S. News/NCQA America’s Best Health Plans annual compilation.1 Excellent Ratings from NCQA Kaiser Permanente: MD KPIF $750/20% w/Rx DHMO. Most services are covered at 100% after you pay your required copayment. This document summarizes the changes and clarifications that Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. is making to your small group DHMO plan(s) effective upon your contract renewal date, which occurs on or after January 1, 2020. U.S. News/NCQA America’s Best Health Plans 2009-101 n Kaiser Permanente Georgia ranked 84 out of 239 commercial HMO competitors in the United States. Al hacer clic en "Continuar", usted regresará al principio de este formulario, y toda la información que haya ingresado en el formulario se perderá. *The premier hospitals are independently owned and operated hospitals, and they contract with Kaiser Foundation Hospitals. outside of the Vancouver/Longview area, continue to kp.org/wa. You’ll need to pay full charges for many . Principal Benefits for Kaiser Permanente Deductible HMO Plan (10/1/20—9/30/21) Accumulation Period The Accumulation Period for this plan is January 1 through December 31. 39999.119.2.S000587142 - DHMO 7587 NCR Actives (continues) 21594 STATE CENTER COMMUNITY COLLEGE . Refer to your ID card or call the Customer Service Center, Monday through Friday, 7:30 a.m. to 9 p.m., Eastern time at 888-225-7202 (TTY. Small Employer Group Deductible DHMO Plus Plans Benefit changes and clarifications for contract year beginning January 1, 2020. Kaiser Permanente 1-866-616-0047 (TTY 711) Features and benefits of our plan: Out-of-pocket costs. EOC #350 - Kaiser Permanente Deductible HMO Plan Evidence of Coverage for . Group ID: 999999902EOC Number: 12 . You pay just a copay for most services. The Hospital Services DHMO plan provides a 17% savings compared to the current Kaiser Permanente $10 Copay Plan.. No Charge, no deductible. October 1, 2018, through September 30, 2019 . The Accumulation Period for this plan is 1/1/18 through 12/31/18 (calendar year). Kaiser DHMO 2500 HDHP 6000 (HSA qualified) With the DHMO plans and the high deductible plan, you must select a medical group and primary care physician (PCP) in the Kaiser Permanente Network although you may receive services without selecting a PCP.
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