- American Indian/Alaskan Native - HMO
- Bronze 6500/35%/HSA
- Bronze 6500/50 - DHMO
- Bronze 7000/50 RX Copay - DHMO
- Bronze 8500/50 - DHMO
- Catastrophic - DHMO
- Gold 0/20 RX Copay - HMO
- Gold 1500/20 - DHMO
- Gold 2000/20 - DHMO
- Select Option Bronze AI-0
- Select Option Bronze AI-LTD
- Select Option Bronze
- Select Option Gold AI-0
- Select Option Gold AI-LTD
- Select Option Gold
- Select Option Silver 73% AV
- Select Option Silver 87% AV
- Select Option Silver 94% AV
- Select Option Silver Enhanced 94% AV
- Select Option Silver AI-0
- Select Option Silver AI-LTD
- Select Option Silver
- Select Option Silver X
- Option Bronze AI-0
- Option Bronze AI-LTD
- Option Bronze
- Option Gold AI-0
- Option Gold AI-LTD
- Option Gold
- Option Silver 73% AV
- Option Silver 87% AV
- Option Silver 94% AV
- Option Silver Enhanced 94% AV
- Option Silver AI-0
- Option Silver AI-LTD
- Option Silver
- Option Silver X
- Select American Indian/Alaskan Native - HMO
- Select Bronze 6500/35%/HSA
- Select Bronze 6500/50 - DHMO
- Select Bronze 7000/50 RX Copay - DHMO
- Select Bronze 8500/50 - DHMO
- Select Catastrophic - DHMO
- Select Gold 0/20 RX Copay - HMO
- Select Gold 1500/20 - DHMO
- Select Gold 2000/20 - DHMO
- Select Silver 1000/20/87% CSR - DHMO
- Select Silver 200/5%/94% CSR - DHMO
- Select Silver 2200/25/73% CSR - DHMO
- Select Silver 2200/25 - DHMO
- Select Silver 2500/20%/73% CSR - DHMO
- Select Silver 275/25/87% CSR - DHMO
- Select Silver 3650/20/73% CSR - DHMO
- Select Silver 3700/20%/HSA
- Select Silver 4000/30 RX Copay 73% CSR - DHMO
- Select Silver 4500/30 RX Copay - DHMO
- Select Silver 50/5/94% CSR - DHMO
- Select Silver 50/5 RX Copay 94% CSR - DHMO
- Select Silver 500/20 RX Copay 87% CSR - DHMO
- Select Silver 5000/25 - DHMO
- Select Silver 755/10/94% CSR - DHMO
- Select Silver 850/10%/87% CSR - DHMO
- Silver 1000/20/87% CSR - DHMO
- Silver 200/5%/94% CSR - DHMO
- Silver 2200/25/73% CSR - DHMO
- Silver 2200/25 - DHMO
- Silver 2500/20%/73% CSR - DHMO
- Silver 275/25/87% CSR - DHMO
- Silver 3650/20/73% CSR - DHMO
- Silver 3700/20%/HSA
- Silver 4000/30 RX Copay 73% CSR - DHMO
- Silver 4500/30 RX Copay - DHMO
- Silver 50/5/94% CSR - DHMO
- Silver 50/5 RX Copay 94% CSR - DHMO
- Silver 500/20 RX Copay 87% CSR - DHMO
- Silver 5000/25 - DHMO
- Silver 75/10/94% CSR - DHMO
- Silver 850/10%/87% CSR - DHMO
Individual & family plan documents
Review plan listings of previous evidence of coverage documents.
- KP CO Bronze 6500/35%/HSA
- KP CO Bronze 6500/50 - DHMO
- KP CO Bronze 7000/50 RX Copay - DHMO
- KP CO Bronze 8500/50 - DHMO
- KP CO Catastrophic - DHMO
- KP CO Gold 0/20 RX Copay - HMO
- KP CO Gold 1500/20 - DHMO
- KP CO Gold 2000/20 - DHMO
- KP CO Silver 2200/25 X - DHMO
- KP CO Silver 3700/20%/HSA X
- KP CO Silver 4500/30 RX Copay DHMO
- KP CO Silver 4500/30 RX Copay X - DHMO
- KP CO Silver 5000/25 X - DHMO
- KP CO Silver 6000/30 X - DHMO
- KP Select CO Bronze 6500/35%/HSA
- KP Select CO Bronze 6500/50 - DHMO
- KP Select CO Bronze 7000/50 RX Copay
- KP Select CO Bronze 7000/50 RX Copay - DHMO
- KP Select CO Bronze 8500/50 - DHMO
- KP Select CO Catastrophic - DHMO
- KP Select CO Gold 0/20 RX Copay - HMO
- KP Select CO Gold 1500/20 - DHMO
- KP Select CO Gold 2000/20 - DHMO
- KP Select CO Silver 2200/25 X - DHMO
- KP Select CO Silver 3700/20%/HSA X
- KP Select CO Silver 4500/30 RX Copay DHMO
- KP Select CO Silver 4500/30 RX Copay X - DHMO
- KP Select CO Silver 5000/25 X - DHMO
- KP Select CO Silver 6000/30 X - DHMO
- KP Select CO Option Bronze DHMO
- KP Select CO Option Gold DHMO
- KP Select CO Option Silver X DHMO
- KP CO Option Bronze DHMO
- KP CO Option Gold DHMO
- KP CO Option Silver X DHMO
Questions?
Kaiser Permanente member
The sample documents may vary from your actual benefits. To view a copy of your specific plan documents, please log into www.kp.org
or contact Member Services.