2022 Kaiser Permanente Coverage

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, as well as the District of Columbia.

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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 co-pays 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.

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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.

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Kaiser Permanente Vision Insurance Overview

Does Kaiser Permanente Cover LASIK?

Kaiser Permanente covers the cost of LASIK at 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.

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1 (844) 612-0518
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