Kaiser Permanente is an integrated healthcare delivery system headquartered in Oakland, California. In addition to offering individual, family, and group health insurance plans, Kaiser Permanente — often referred to as Kaiser — also operates the Kaiser Foundation Health Plan, Inc., Kaiser Foundation Hospitals, and the regional Permanente Medical Groups. 

With more than 12 million members, Kaiser Permanente is one of the largest nonprofit healthcare plans in the U.S.

Kaiser Permanente Operating States

Currently, Kaiser Permanente operates in eight U.S. states: Hawaii, Washington, Oregon, California, Colorado, Maryland, Virginia, Georgia, and the District of Columbia.

Health Insurance Offerings Overview: Explore Kaiser Permanente Insurance Plans

Kaiser health insurance is robust. The company offers most types of health insurance to meet the needs of patients. Kaiser Permanente health insurance plans are available through membership-based policies. The company offers both individual and family plans, including:

• Copay plans
• Deductible plans
• Virtual plans
• HSA qualified plans
• Catastrophic plans 

Consider the following types of insurance plans available. 

Health Insurance

Kaiser Permanente offers health maintenance organization (HMO) and preferred provider organization (PPO) insurance plans.

HMO provides a defined network of healthcare providers that you can select from at a preset, preapproved rate. You have a primary care doctor who manages your care and refers you to specialists within the network when you need added help. Some types of care can be obtained directly, such as optometry. 

PPO plans allow you to see any doctor, whether that doctor is within or not within the network you choose. You have a network of preferred providers, and when you see these providers, you tend to pay less. You can also get specialty care when you need it without needing a referral to do so. 

Within these insurance plans, Kaiser offers different tiers of coverage:

• Bronze: This tends to have the lowest monthly premium, highest deductible, and highest out-of-pocket costs for care.
• Silver: These policies have a more moderate premium, deductible, and out-of-pocket expenses 
• Gold: The monthly premium is higher, but the deductible is lower, as are the out-of-pocket costs for care
• Platinum: This plan has the highest monthly premium with the lowest deductible and out-of-pocket costs.

Medicare Supplemental Insurance

Kaiser Permanente offers Medicare Advantage plans, also known as Medicare Part C coverage. You can choose this coverage instead of Original Medicare if you meet the qualifications for coverage. These plans include the following for 2025:

• Medicare Advantage Liberty (HMO) plan without Part D
• Medicare Advantage Care Plus VA (HMO-POS) plans
• Medicare Advantage Care Plus MD (HMO-POS) plan 

Medigap Coverage

In addition, for those who have Original Medicare, it may be helpful to purchase Medigap coverage. This type of coverage from Kaiser pays for your out-of-pocket expenses, co-insurance, and some other costs that your Medicare plan does not cover. 

Medicare Prescription Drug Coverage

Kaiser Permanente offers Medicare Part D drug coverage. These policies allow you to get coverage for your prescription medications. This is a necessary additional policy for those who have Original Medicare since Original Medicare does not cover prescription drugs. 

Kaiser Permanente Health Insurance Overview

Does Kaiser Permanente Cover Acupuncture?

Kaiser Permanente covers acupuncture under its Kaiser Permanente Supplemental Chiropractic and/or Acupuncture Plans, which must be purchased separately from individual or family plans. The initial examination, any emergency or urgent acupuncture service, and any services that are not available from participating providers or licensed providers with ASH contracts are not covered.

This supplemental plan is in coordination with the American Specialty Health Plans of California, Inc. (ASH Plans). Confirm this supplemental acupuncture plan availability in your state individually if you live outside of California.

Does Kaiser Permanente Cover Chiropractic Care?

Yes, Kaiser Permanente covers chiropractic care under the Kaiser Permanente Supplemental Chiropractic and/or Acupuncture Plans, which must be purchased separately from individual or family plans. 

Chiropractic services are covered by Kaiser Permanente when they are provided by a participating provider and are determined to be medically necessary for the treatment or diagnosis of neuromusculoskeletal disorders. 

Please note: This supplemental plan is in coordination with the American Specialty Health Plans of California, Inc. (ASH Plans). Confirm this chiropractic coverage availability in your state individually if you live outside of California.

Does Kaiser Permanente Cover Allergy Testing?

Kaiser Permanente plans typically cover allergy testing when medically necessary or referred by your primary care practitioner (PCP). Specific services and differences in copays may vary by region. 

Does Kaiser Permanente Cover Gender Reassignment Surgery?

When gender reassignment surgery and related procedures are medically necessary to treat gender dysphoria, these surgeries and procedures are covered by Kaiser Permanente. 

Kaiser Permanente prides itself on caring for transgender members and their families with respect and dignity and aligns with the World Professional Association for Transgender Health (WPATH) standards of care.

Does Kaiser Permanente Cover Birth Control?

Yes, Kaiser Permanente covers birth control. The Affordable Care Act allows Kaiser Permanente members to access certain types of birth control at little to no cost. 

Does Kaiser Permanente Cover Breast Reduction Surgery?

Kaiser Permanente may cover breast reduction surgery if the surgery is determined to be medically necessary. Cosmetic procedures are not covered. 

Does Kaiser Permanente Cover Infertility?

Kaiser Permanente covers some infertility treatments. 

These include:  

• Initial office visit
• Including a pelvic exam, routine blood tests, cultures, and a Pap smear as needed
• Instructions and resources for basal temperature monitoring
• Second office visit
• Recommended referrals 

Kaiser’s employer group plans may offer additional infertility coverage. 

Does Kaiser Permanente Cover STD Testing?

Some STI/STD testing, such as HIV testing, is covered as it is considered routine, preventive care by Kaiser Permanente.

Some diagnostic testing, such as testing for herpes, HPV, syphilis, and other sexually transmitted viruses, is typically covered when deemed medically necessary.

Kaiser Permanente Mental Health Insurance Overview

Does Kaiser Permanente Cover Mental Health?

Kaiser Permanente offers a broad range of mental health coverage options for medication and therapy. Most plans will require some out-of-pocket fees, but these are generally low, averaging less than $50 per service or visit.

Does Kaiser Permanente Cover Therapy?

Kaiser Permanente covers costs related to therapy and counseling, including services and care from psychiatrists, medication management, and other social services. Read more about services and available support here. 

Kaiser Permanente Dental Insurance Overview

Does Kaiser Permanente Cover Dental Care?

Kaiser Permanente’s dental insurance plans, which cover various diagnostic, preventive, and orthodontic procedures, must be purchased separately from medical insurance plans. Available deductibles and average out-of-pocket costs vary for each plan. 

Does Kaiser Permanente Cover Braces?

Kaiser Permanente dental plans offer orthodontic coverage, which includes braces. When orthodontic procedures and devices, such as braces, are deemed medically necessary for individuals under 18 years of age, Kaiser Permanente typically offers 50% coverage. Confirm this coverage percentage with your state’s individual dental insurance plan.

Does Kaiser Permanente Cover Braces For Adults?

Adult braces are not covered by Kaiser Permanente dental plans.  

Does Kaiser Permanente Cover Dental Surgery?

Kaiser Permanente’s dental plans cover some types of dental surgery. Typically, the coverage associated with a given dental surgery is based on medical necessity dictated by the dentist. 

Does Kaiser Permanente Cover Wisdom Teeth Removal?

Some types of oral surgery, including wisdom teeth removal, are covered by Kaiser Permanente’s dental plans. Typically, the coverage associated with a given dental surgery is based on medical necessity. 

Does Kaiser Permanente Cover Dental Implants?

Kaiser Permanente’s dental insurance plans cover some dental implants. Check with your state’s plan to better understand the requirement for coverage or the contribution of your Kaiser Permanente dental plan.

Kaiser Permanente Vision Insurance Overview

Does Kaiser Permanente Cover LASIK?

Kaiser Permanente covers the cost of LASIK on a fee-for-service basis. 

Does Kaiser Permanente Cover Cataract Surgery?

Kaiser Permanente’s individual insurance plans do not cover cataract surgery. Some employer-provided plans and flex spending accounts may offer coverage.

Kaiser Permanente Prescription Drug Insurance Overview

Does Kaiser Permanente Cover Hearing Aids?

In some cases, Kaiser Permanente offers coverage for hearing aids through Kaiser Permanente Hearing Centers. Necessary hearing tests, which are generally conducted at Kaiser Permanente facilities, are always covered. 

Many other hearing-related services conducted at Kaiser Permanente facilities are provided on a fee-for-service basis, separate from and not covered under your Health Plan benefits. 

Does Kaiser Permanente Cover Blood Pressure Monitors?

Kaiser Permanente covers some durable medical equipment for home use. Members require a referral from their physician, and coverage is dependent on individual health plans.

Does Kaiser Permanente Cover Cialis?

Kaiser Permanente’s health insurance plans cover Cialis (Tadalafil) when it is deemed medically necessary to treat adult male erectile dysfunction, bladder outlet obstruction, or prostate gland enlargement. 

Does Kaiser Permanente Cover Chantix?

Yes, Kaiser Permanente’s prescription medication coverage includes Chantix for members who have a diagnosis of tobacco or nicotine dependence, are over the age of 18, and have a history of failure with other smoking cessation methods.

Does Kaiser Permanente Cover the shingles vaccine?

Coverage of the shingles vaccine may vary by plan and is typically reserved for patients 50 or 60 years old and older.

Why Choose Kaiser Permanente for Health Coverage?

Kaiser Permanente offers competitive health insurance policies to meet most needs. Their policies are available for most needs, including maternity, mental health, fertility care, transgender services, and more. The company also offers extensive preventative care coverage within its policies. You can choose from a range of policy options to meet most needs. 

How to Enroll in Kaiser Permanente Insurance

If you are considering enrolling in a Kaiser Permanente insurance plan, speak to a licensed agent. Doing so allows you to get a free quote that offers specialized offers and pricing for your specific situation. 

FAQs

What changes are there to Kaiser Permanente coverage for 2025?

There are a variety of changes that happen each year. Here’s a look at those that were updated for 2025 at Kaiser Permanente. 

• Rates: Kaiser updated rates to most plans to reflect inflation. Rates for Kaiser for 2025 are specifically dependent on location as well as your age and needs. The average medical PPO increase was 7% of the average annual increase. (source)
• Plan changes: The Bronze 60 HMO 5400/60 PCP + Dental Alt was discontinued and replaced.
• Benefits: There were no changes to dental, acupuncture, or chiropractic ancillary product benefits.