Care and Coverage | Kaiser Permanente (2024)

Care and Coverage | Kaiser Permanente (1)

Kaiser Permanente has been providing high-quality health care and coverage for more than 75 years. By connecting care with coverage, we pioneered a new model for health care, where things are designed to work together — and help our members thrive. Our care model enables our teams to think and work as one, coordinating your care seamlessly, so you don’t have to — and delivering better care when it matters most.

Care that’s built to support your total health1

Care and Coverage | Kaiser Permanente (2)

Care teams

23,271 physicians
64,306 nurses

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Care and Coverage | Kaiser Permanente (3)

Facilities

39 hospitals
715 medical offices

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Health plans

Providing care and coverage for over 12.4 million members

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Better care from a connected team

When you’re a Kaiser Permanente member, your whole care team is connected — to you, and to each other — through your electronic health record. Every visit is captured, so your doctor can use your health history to inform your care. If you need to see a specialist, they’ll have important information about your health before they even meet you in person.2 And when you fill a new prescription, your pharmacist can make sure it’s safe to take with your other medications. This enables us to deliver the right care faster — and help members avoid unnecessary visits, serious health conditions, and sleepless nights.

Care and Coverage | Kaiser Permanente (5)

Connected care makes your life easier

Our doctors, hospitals, and health plans are all part of one team. That means your eye doctor can remind you if you’re overdue for a cancer screening. And the app you use to view your lab results is the same one you use to pay your bills. It takes the hassle out of health care — so you can focus on living your life.

See what it's like to be a member

A partner in health

When everything about your health care, including your health plan, is connected, everyone is equally invested in your total health. We take an active role in helping to keep you healthy from the minute you become a member — not just when you get sick or injured. Because of our care model, it’s in everyone’s best interest to provide the right care, not more care — and when our members thrive, everyone wins.

Preventive care to help you stay ahead of health problems

Many common health conditions are preventable — so a proactive approach to prevention is the foundation of how we practice medicine. When you’re a Kaiser Permanente member, your electronic health record triggers automatic reminders for screenings, so we can let you know when it’s time to make an appointment. Your care team sees a complete picture of your health at every visit. And your care gets documented along the way. It’s how we help many members avoid serious health issues, and help others catch problems before they’re serious.

Specialty care you can trust

When faced with serious health problems, you’ll get great doctors, the latest technology, and evidence-based care — all working together to support your journey back to health.

Learn more about our specialty care

A leader in clinical quality3

In 2019, Kaiser Permanente led the nation as the top performer in:

  • Prevention and screening
  • Cardiovascular care
  • Comprehensive diabetes care
  • Mental health
  • Maternity care

Convenient, hassle-free health care

You expect convenient options from restaurants, retailers, and banks — so why not health care? At Kaiser Permanente, you can get care where, when, and how you want it. With more options to choose from, it’s easier to stay on top of your health. And isn’t that what health care is for?

Choose how you see your doctor

Care and Coverage | Kaiser Permanente (6)

Video Visit4

Care and Coverage | Kaiser Permanente (7)

Phone appointment4

Care and Coverage | Kaiser Permanente (8)

In person

More simple ways to get care in the moment

E-visit

Fill out a short questionnaire about your symptoms online and get personalized self-care advice from a Kaiser Permanente health care professional.

24/7 care and advice by phone

Call us for advice when you need it most. We’ll help you find out what care is right for you, schedule appointments, and more.

Email

Message your doctor’s office anytime with nonurgent health questions.5 You’ll get a response usually within 2 business days.

The Kaiser Permanente app

Download the app to manage routine appointments, refill most prescriptions for mail-order delivery, see most test results, and more.6,7

More than just health care — support for healthy living

We’re here to help you stay healthy — not just take care of you if you get sick. Good health goes beyond the doctor’s office, and living a healthy lifestyle can help you thrive for years to come. That’s why we support our members in ways that go beyond providing great health care, including:8

  • Special rates on fitness classes, gym memberships, fitness gear, and more.
  • Wellness apps to help improve sleep, mood, relationships, and emotional health.
  • Personalized online programs to help you lose weight, quit smoking, reduce stress, and more.

Built to be different — and better

Having a good health plan is important. So is getting high-quality care. Kaiser Permanente was built to give you both.

Telehealth and convenient, connected care

See why telehealth works best in a connected system — and how that benefits you.

Making the most of your doctor’s appointment

Find out how to get the most out of the time you spend with your doctor.

5 health care terms to know

Learning these common health care terms can help you plan for the cost of your care.

Shop our plans

Compare all our health plan options, get a quote, and apply online.

Shop plans

Doctors and locations

Find top-notch doctors, specialists, and pharmacies near you.

Find doctors and locations

Thrive together

Discover new ways to thrive — in mind, body, and spirit.

Read articles


1
Data as of June 2020.
2When you get care from Kaiser Permanente providers.
3Kaiser Permanente 2019 HEDIS® scores. Benchmarks provided by the National Committee for Quality Assurance (NCQA) Quality Compass® and represent all lines of business. Kaiser Permanente combined region scores were provided by the Kaiser Permanente Department of Care and Service Quality. The source for data contained in this publication is Quality Compass 2019 and is used with the permission of NCQA. Quality Compass 2019 includes certain CAHPS® data. Any data display, analysis, interpretation, or conclusion based on these data is solely that of the authors, and NCQA specifically disclaims responsibility for any such display, analysis, interpretation, or conclusion. Quality Compass® and HEDIS® are registered trademarks of NCQA. CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality.
4When appropriate and available.
5When you get care from Kaiser Permanente facilities.
6See note 5.
7To use the Kaiser Permanente app, you must be a Kaiser Permanente member registered on kp.org.
8The services described are not covered under your health plan benefits and are not subject to the terms set forth in your Evidence of Coverage or other plan documents. These services may be discontinued at any time without notice.

Care and Coverage | Kaiser Permanente (2024)

FAQs

Are Kaiser and Kaiser Permanente the same? ›

Kaiser Permanente is made up of three distinct but interdependent groups of entities: the Kaiser Foundation Health Plan, Inc. (KFHP) and its regional operating subsidiaries; Kaiser Foundation Hospitals; and the regional Permanente Medical Groups.

What is the difference between Kaiser HMO and PPO? ›

With a PPO plan, you can see any provider you choose, whether they are in your network or not, without needing a referral. Another key difference between HMO vs PPO and PPO plans is the out-of-pocket costs. HMO plans generally have lower out-of-pocket costs, with fixed copayments for most services and no deductibles.

Does Kaiser cover pre-existing conditions? ›

Do you or anyone in your household have a medical condition? This will help us recommend plans that fit your specific health needs and determine if you might qualify for financial assistance. You'll never be denied coverage based on a pre-existing condition.

How is Kaiser different from other insurance? ›

Unlike a traditional insurance company, we are a membership-based, prepaid, direct health care system.

Why are doctors leaving Kaiser permanent? ›

The report, by Mark Roberts, M.D., chief of medicine at Kaiser's Vallejo Medical Center, said many physicians are leaving Kaiser for "less demanding jobs" elsewhere or cutting back on their Kaiser work schedules, resulting in a 13 percent turnover rate over the last two to three years.

Who is Kaiser Permanente's biggest competitor? ›

Kaiser Permanente competitors and alternatives
  1. UnitedHealth Group. Provider of comprehensive array of products and services ranging from insurance consulting to benifits management. ...
  2. Humana. Provider of health insurance services. ...
  3. Anthem. ...
  4. WellCare Health Plans. ...
  5. Aetna. ...
  6. CareFirst. ...
  7. IBX. ...
  8. Universal American.
Jul 18, 2024

Why do doctors prefer PPO over HMO? ›

The key difference lies in the flexibility of choosing providers and the need for referrals in HMOs. Why do doctors prefer PPO? Doctors often prefer PPOs because they offer greater reimbursem*nt rates compared to HMOs and have less administrative paperwork.

What is a disadvantage of choosing Kaiser? ›

Limited Coverage Area: Kaiser Permanente is only available in eight states, which restricts access for individuals living outside these areas. This limitation means that many potential members cannot benefit from Kaiser's integrated healthcare system and quality care, reducing the organization's reach and impact.

What are the two most common health insurance plans? ›

Preferred provider organization (PPO) plan. Health maintenance organization (HMO) plan.

Can you be denied health insurance for pre-existing conditions? ›

Yes. Under the Affordable Care Act, health insurance companies can't refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts.

What are the most common pre-existing conditions? ›

What are some examples of pre-existing health conditions? Chronic illnesses and medical conditions, including many forms of cancer, diabetes, lupus, epilepsy, and depression may be considered pre-existing conditions. Pregnancy before enrollment is also considered pre-existing and chronic.

What states is Kaiser Permanente in? ›

What is a Kaiser Permanente service area? A Kaiser Permanente service area is a geographical area where there are Kaiser Permanente medical offices. Kaiser Permanente service areas include all or parts of: • California • Colorado • Georgia • Hawaii • Maryland • Oregon • Virginia • Washington • Washington, D.C.

Why do people choose Kaiser? ›

Convenient, hassle-free health care

At Kaiser Permanente, you can get care where, when, and how you want it. With more options to choose from, it's easier to stay on top of your health.

What kind of reputation does Kaiser Permanente have? ›

Kaiser Permanente receives 5 out of 5 stars for overall quality of care from the Office of the Patient Advocate and Covered California. The Office of the Patient Advocate also gave our plans 5 out 5 stars for mental health care in its 2023-24 Health Care Quality Report Card.

What is a disadvantage of a PPO plan? ›

What Are Disadvantages of PPO Plans? PPO plans tend to be more expensive than other managed-care options. They typically have higher monthly premiums and out-of-pocket costs, like deductibles.

What is another name for Kaiser Permanente? ›

In 1984, the region opened its first pharmacy and officially changed its name to Kaiser Foundation Health Plan of the Mid-Atlantic States. Founded in 1980, Kaiser Permanente of the Mid-Atlantic States, headquartered in Washington, D.C., comprises: Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.

What states use Kaiser Permanente? ›

A Kaiser Permanente service area is a geographical area where there are Kaiser Permanente medical offices. Kaiser Permanente service areas include all or parts of: • California • Colorado • Georgia • Hawaii • Maryland • Oregon • Virginia • Washington • Washington, D.C.

Is Kaiser International the same as Kaiser Permanente? ›

KP International is a self-supporting, not-for-profit educational subsidiary of Kaiser Permanente.

Is Kaiser Family Foundation the same as Kaiser Permanente? ›

KFF is not a foundation and has no connection to Kaiser Permanente.

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