Help with cost estimates and prepaying for scheduled care

When you make an appointment, we’ll create a cost estimate for the care you’ll receive. We’ll send a text or email with a direct link to the estimate in your kp.org account when it’s ready.

Your estimate will detail the total cost of your care and the amount due at the time of your visit. You can prepay to save time at check-in.

Your estimate is based on:

• Your coverage and how much you’ve paid toward your out-of-pocket maximum
• How much you’ve paid towards your deductible, if you have one
• The services you scheduled
• Where you’re getting care

Estimated costs for services may be different than the final bill. Your costs can change if you get more or different services than you scheduled.

Cost estimates for scheduled visits are on the Financial Estimates page in your kp.org account. They stay in your account until your visit.

You’ll get an estimate soon after scheduling a visit. When it’s ready, we’ll send you a text or email with a link to the estimate in your kp.org account.

For now, not all visits or services create a cost estimate. You won’t get an estimate if:

• You get care the same day you make your appointment
• You’re getting basic preventive care 
• You’re getting certain specialized care, like inpatient surgery or infusion therapy
• You have more than one health plan (also called dual coverage)
• You’ve reached your out-of-pocket maximum
• Kaiser Permanente Medical Financial Assistance covers the full cost of your care

Yes. You can use the cost calculator anytime and search by:

• Keyword
• Category
• Procedure code

The cost calculator will show you an amount based on your coverage and how much you’ve spent on care so far this year.

Note: The cost calculator can give you a good idea of what you may pay, but the actual cost may be different. Your final bill depends on which services you end up getting and how much you’ve spent on care at the time of your visit.

In the past, you may have paid for care when you arrived for your visit. With personalized estimates and the option to prepay, you get:

• Upfront clarity about your total health care costs
• Reduced chances of getting a surprise bill
• A streamlined check-in process

Your benefits and total cost for care haven’t changed.

If you can’t pay the whole prepay amount before your visit, don’t cancel or reschedule care. Talk to the receptionist about your payment options when you check in.

You don’t have to prepay online. You can choose to pay when you arrive for your visit instead. If you can’t pay the whole cost estimate, talk to the receptionist about your options when you check in.

Looking for ways to manage your health care costs? We offer a variety of resources for help paying your bills.

You have 3 ways to prepay:

• By selecting “Make payment” on your estimate
• When you check in online — up to 4 days before your visit
• At a kiosk or the front desk when you arrive for your visit

You can find your cost estimates for scheduled visits on the Financial Estimates page in your kp.org account.

Your copay is included in your prepay amount.

For many people, the prepay amount and the copay are the same thing.

For people with a deductible plan, the prepay amount goes toward what they owe toward their deductible, or it covers their copay and any coinsurance charges.

Your prepay amount is what we estimate you’ll owe for the cost of your care, based on:

• Your coverage and how much you’ve paid toward your out-of-pocket maximum
• How much you’ve paid towards your deductible, if you have one
• The services you scheduled
• Where you’re getting care

For many people, the prepay amount is the same as the copay.

If you have a deductible plan, your prepay amount goes toward what you owe towards your deductible, or it covers your copay and any coinsurance. Before, you may have been billed for some costs after getting care. Now, you’re paying them all upfront. This gives you a better understanding of the total costs of your care and reduces your chance of getting a surprise bill later.

If you can’t pay the whole prepay amount before your visit, don’t cancel or reschedule care. Talk to the receptionist about your payment options when you check in.

No. Your estimate and prepay amount are just that — an estimate for the cost of your scheduled visit.

During your appointment, your care team may recommend more services depending on your health needs. These services may have extra costs, so you’d be billed for them later.

For now, not all visits will get a cost estimate. You won’t get an estimate if:

• You get care the same day you make your appointment
• You’re getting basic preventive care
• You’re getting certain specialized care, like inpatient surgery or infusion therapy
• You have more than one health plan (also called dual coverage)
• You’ve reached your out-of-pocket maximum
• Kaiser Permanente Medical Financial Assistance covers the full cost of your care

More types of visits will be added to the estimate tool over time.

Please note: Even if you don’t get an estimate, you could still owe money for your care. You can always ask about your care costs when you check in for your visit.

Your cost estimate and prepay amount are based on the services you scheduled when you made your appointment. If you get more or different services than what was scheduled, your prepayment may not cover your costs for care. If this happens, you’ll get a bill later.

If you get different services than you scheduled, your final bill could be lower than what you prepaid. If you have any unpaid bills or cost estimates on your account for upcoming visits, your overpayment will be used to help cover them. If not, you’ll get a refund.

If you have any unpaid bills or cost estimates on your account for upcoming visits, your prepayment will be used to help cover them. If not, you’ll get a refund.

As a member, you have options to help manage the costs of your care. You can:

• Talk to a Kaiser Permanente financial counselor
• Set up a payment plan
• Apply for our Medical Financial Assistance program, which can help cover your health care costs

Call Member Services if you need help connecting to any of these resources.