Your guide to COVID-19

If you’re a member of an individual and family plan or employer-sponsored plan, COVID-19 services — such as the vaccine, tests, and treatment — are covered when you get them at a Kaiser Permanente facility.

If you get COVID-19 services from providers not in Kaiser Permanente’s network, you may be able to get up to half of their cost reimbursed.

If you get COVID-19 services as part of urgent or emergency care, you may be able to get the full cost reimbursed.

To submit a claim for reimbursement:

• Visit kp.org/billing.
• Go to the “Understand your costs” section.
• Click “Submit a claim.”

If you’re a Medi-Cal member, COVID-19 services are covered at no cost, whether you get them at a Kaiser Permanente facility or from an out-of-network provider.

If you’re a Medicare member, COVID-19 services are covered according to the following federal Medicare rules:

• COVID-19 vaccines are covered at no-cost. 
• PCR tests and treatment is covered with applicable plan out-of-pocket costs.
• Home antigen tests are not covered. 
• COVID-19 care, such as vaccines, testing, and medications, received out-of-network will only be covered for emergency and urgent care situations, when legally required, or when out-of-network coverage is included in your plan. 

People with COVID-19 may have mild to severe symptoms, including fever, cough, and difficulty breathing. Other symptoms may include chills, muscle pain, headache, sore throat, and loss of smell or taste. While patient information shows most cases are mild, symptoms tend to be more severe in older adults and people with chronic conditions.

Everyone 6 months and older should get the latest COVID-19 vaccine to protect themselves from severe illness. The Centers for Disease Control and Prevention also recommends that adults ages 65 years and older receive an additional dose of the updated COVID-19 vaccine at least 4 months after their first dose of the updated vaccine, which became available in fall 2023.

It’s especially important to get vaccinated if you’re at high risk for complications from COVID-19. Older people and those with weakened immune systems have a greater risk for hospitalization and even death from the virus. However, even healthy children and adults can get seriously ill from COVID-19.

Learn more about the vaccine.

The Centers for Disease Control and Prevention recommends that adults ages 65 years and older receive an additional dose of the updated COVID-19 vaccine at least 4 months after their first dose of the updated vaccine, which became available in fall 2023. We expect to begin administering this additional dose of the updated COVID-19 vaccine to older adults in most areas by mid-March, and possibly earlier in some locations.

Learn more about the vaccine.

Paxlovid is a treatment for people who have an active COVID-19 infection and are at high risk for serious illness. It’s available by prescription at Kaiser Permanente pharmacies. Your care team may recommend it if:

• You’re 12 or older
• You’ve recently tested positive for COVID-19
• Your symptoms started within the last 5 days
• You have health conditions that put you at high risk for serious illness from COVID-19

For some people, Paxlovid may have 2 mild side effects: a metallic taste in the mouth and diarrhea. These side effects will go away once you’ve finished taking Paxlovid. Also, your care team will check what medications you’re taking and determine if any of them need to be held or have dosing changed while you are taking Paxlovid.