HMO plans

With a Kaiser Permanente HMO plan, expect predictable costs for care and no deductibles. You’ll know from the start how much your copays or coinsurance are for services and prescriptions.

The cost of your visit depends on your plan, the care you need, and how much you’ve paid toward your out-of-pocket maximum. Before your visit, you can get a personalized cost estimate to help avoid surprises.

Your copay or coinsurance depends on many factors, including your plan details, how much you’ve already paid for care, and the type of care you receive. To learn about your plan’s copay or coinsurance details, sign in to your kp.org account.

Most copays and coinsurance will count toward your out-of-pocket maximum. To learn more about your copays or coinsurance and track your out-of-pocket maximum, sign in to kp.org.

Even though you made a payment at check in, you can expect an additional bill if your payment didn’t fully cover all of your scheduled medical services or if you received additional services during the visit. If the care you received costs more than what you paid at your visit, you’ll usually receive a bill within 30 days. 

Preventive care, like routine exams and screenings, is typically covered by most health plans at no extra cost and is used to identify or prevent illnesses and diseases before symptoms appear. During a preventive care visit, your doctor may recommend additional services or tests that come with extra costs; these are called <a href="/learn/doctor-visit-costs">diagnostic services</a> and are different from <a href="/learn/preventive-services">preventive care</a>.

Learn more about preventive care, including a complete list of available preventive services, or refer to your <a href="/mc/benefit-summary">Benefit summary</a> to explore which preventive services are covered under your plan.

Yes. As a Kaiser Permanente member, you are covered for urgent and emergency care anywhere in the world.

How much you pay depends on your plan. When and how you pay can also depend on where you get care.

If your plan covers care in other Kaiser Permanente areas, you will pay your normal costs, like a copay, coinsurance, or deductible. If you owe more, you will get a bill later.

For urgent or emergency care in the U.S., you may have to pay the full cost at the time of care. If you do, you will need to file a claim to get money back later. Sometimes, the provider may bill Kaiser Permanente directly.

Most Kaiser Permanente plans cover urgent and emergency care worldwide. If you are traveling outside the U.S., you may need to pay the full cost first and then file a claim for reimbursement later.

Find more detailed information about your plan’s coverage online or in your <i>Evidence of Coverage</i> or other coverage documents.