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Only payments made toward the full cost of covered services applies toward the deductible limit.
Some services may only require a copay or coinsurance, and those payments count toward your out-of-pocket maximum limit.
How your plan works
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There are three phases to your GENERAL POST 65 plan.
Phase 1 - Before Deductible is met
In this phase, you’ll pay full cost for certain medical services. However, some services may only require a copay or coinsurance.
When you’ve reached your deductible limit, only you will move on to the next phase. When your family has reached the deductible limit, both you and your family will move on to the next phase.
Deductible contributions
You're in this phase
Phase 2 - Deductible is met
In this phase,you’ll pay a share of the costs . You’ll pay for covered services with a copay or coinsurance until you or your family have reached the out-of-pocket maximum limit.
Phase 3 - Out-of-pocket maximum is met
In this phase, you won’t need to pay for covered services.
When you’ve reached your out-of-pocket maximum limit, Kaiser Permanente will only pay for your covered services.
To learn about your share of costs for a specific medical service, view your Benefit summary.
The paid amounts shown are based on you and your family’s spending from January 2, 2024 to January 1, 2025. After that date, the total amount you’ve paid will reset to $0.00 and only new medical bill payments will be considered.