- Summary of Benefits and Coverage (2019)
- Summary of Benefits and Coverage (2018)
- Vision Essentials by Kaiser Permanente (2018)
Under the Kaiser Health Maintenance Organization (HMO) plan, you choose a primary care physician (PCP) who coordinates all of your medical care within the Kaiser network. Kaiser Permanente has 33 centers located throughout the Washington, DC metropolitan area. Some centers serve as after hours care centers, where participants with urgent medical problems may be seen when regular medical centers are closed.
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With the exception of life threatening emergency treatment, participants must receive care through Kaiser centers. Hospitalization coverage is included at area hospitals associated with Kaiser.
- You must select a PCP in order to obtain care within the network
- As needed, your PCP will refer you to specialists within the network
- Except in emergency situations, coverage is not provided for care received outside the network
- You pay a copayment for each visit to a physician’s office
Online Resources for Kaiser Members
Learn how to see your lab results, access your medical records, make and review future doctor's appointments, check immunizations and contact your physician - online! Through Kaiser's My Health Manager program Kaiser members have access to a host of online resources at no extra cost. Click here to find out more.
Prescription Drug Plan
Kaiser covers prescription drugs with a $15/$25/$40 copayment for prescriptions purchased at a Kaiser center and a $20/$45/$60 copayment for prescriptions purchased at a participating community pharmacy. No reimbursement is made for prescriptions purchased outside of a Kaiser center or participating community pharmacy. Mail order pharmacy is also available for 90-day supply.
Filing a Claim
There are no claim forms for this plan. If you pay for any services (including prescription expenses) out-of-pocket, Kaiser will not reimburse you for those expenses.