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- KP HI Bronze 6000/65 Plus CAM AI/AN 100%
- KP HI Bronze 6000/65 Plus CAM AI/AN LTD
- KP HI Bronze 6000/65 Plus CAM
- KP HI Bronze 6500/30% AI/AN 100%
- KP HI Bronze 6500/30% AI/AN LTD
- KP HI Bronze 6500/30%
- KP HI Gold 0/40 Plus CAM AI/AN 100%
- KP HI Gold 0/40 Plus CAM AI/AN LTD
- KP HI Gold 0/40 Plus CAM
- KP HI Gold - AI/0
- KP HI Gold 1000 Ded/250 Rx Ded AI/AN LTD
- KP HI Gold 1000 Ded/250 Rx Ded
- KP HI Platinum 0/5 Plus CAM AI/AN 100%
- KP HI Platinum 0/5 Plus CAM AI/AN LTD
- KP HI Platinum 0/5 Plus CAM
- KP HI Silver 0/5 CSR94 Plus CAM
- KP HI Silver 25/5 CSR94
- KP HI Silver 250 Ded/100 Rx Ded CSR87 Plus CAM
- KP HI Silver 2850 Ded/600 Rx Ded CSR73 Plus CAM
- KP HI Silver 3000 Ded/500 Rx Ded CSR73
- KP HI Silver - Plus CAM AI/0
- KP HI Silver 3000 Ded/600 Rx Ded Plus CAM AI/AN LTD
- KP HI Silver 3000 Ded/600 Rx Ded Plus CAM
- KP HI Silver - AI/0
- KP HI Silver 4000 Ded/600 Rx Ded AI/AN LTD
- KP HI Silver 4000 Ded/600 Rx Ded
- KP HI Silver 750/20 CSR87
- KP HI Standard Bronze 7500/50 AI/AN 100%
- KP HI Standard Bronze 7500/50 AI/AN LTD
- KP HI Standard Bronze 7500/50
- KP HI Standard Gold 1500/30 AI/AN 100%
- KP HI Standard Gold 1500/30 AI/AN LTD
- KP HI Standard Gold 1500/30
- KP HI Standard Platinum 0/10 AI/AN 100%
- KP HI Standard Platinum 0/10 AI/AN LTD
- KP HI Standard Platinum 0/10
- KP HI Standard Silver 0/0 CSR94
- KP HI Standard Silver 5700/40 CSR73
- KP HI Standard Silver 5900/40 AI/AN 100%
- KP HI Standard Silver 5900/40 AI/AN LTD
- KP HI Standard Silver 5900/40
- KP HI Standard Silver 700/20 CSR87
Individual & family plan documents
Review plan listings of previous evidence of coverage documents.
- KP HI Bronze 6000/65
- KP HI Bronze 6000/65 PedDent
- KP HI Bronze 6000/65 Plus CAM
- KP HI Bronze 6000/65 Plus CAM PedDent
- KP HI Bronze 6500/30%
- KP HI Bronze 6500/30% PedDent
- KP HI Gold 0/40
- KP HI Gold 0/40 PedDent
- KP HI Gold 0/40 Plus CAM
- KP HI Gold 0/40 Plus CAM PedDent
- KP HI Gold 1000 Ded/250 Rx Ded
- KP HI Gold 1000 Ded/250 Rx Ded PedDent
- KP HI Platinum 0/5
- KP HI Platinum 0/5 PedDent
- KP HI Platinum 0/5 Plus CAM
- KP HI Platinum 0/5 Plus CAM PedDent
- KP HI Silver 3000 Ded/600 Rx Ded
- KP HI Silver 3000 Ded/600 Rx Ded Plus CAM
- KP HI Silver 3000 Ded/600 Rx Ded PedDent
- KP HI Silver 3000 Ded/600 Rx Ded Plus CAM PedDent
- KP HI Silver 4000 Ded/600 Rx Ded
- KP HI Silver 4000 Ded/600 Rx Ded PedDent
- KP HI Standard Bronze 7500/50
- KP HI Standard Bronze 7500/50 PedDent
- KP HI Standard Gold 1500/30
- KP HI Standard Gold 1500/30 PedDent
- KP HI Standard Platinum 0/10
- KP HI Standard Platinum 0/10 PedDent
- KP HI Standard Silver 5900/40
- KP HI Standard Silver 5900/40 PedDent
Questions?
Have questions about the sample plan documents? Visit buykp.org
or call 808-432-5955
(Oahu) and 1-800-966-5955
(Neighbor Islands) (TTY 711
).
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.