Kaiser Permanente: Overview

Kaiser Permanente is a health insurance provider based in Oakland. They provide coverage in 7 states and in Washington DC.

Smart Score

Compare Health Insurance Rates in Your Area

About Kaiser Permanente

The Kaiser industrial companies of the 1930s and 1940 offered industrial health care programs for construction, shipyard and steel mill workers.These programs were opened to the public for enrollment in July 1945. 

It was during the Great Depression that it all began Dr. Sidney Garfield, MD began a 12-bed hospital in the Mojave Desert  called Contractors General Hospital, where he treated sick and injured workers. He had trouble collecting from insurance companies in a timely manner, and some workers had no insurance at all. 

To take care of the hospitals financial problems, Harold Hatch, an engineer who became an insurance agent suggested that companies pay Dr. Garfield a fixed amount per day, per covered worker up front. For five cents a day, workers received health coverage, with the option of another five cents a day to take care of non-work related health problems. After thousands of workers joined the prepay health plan, the hospital became a success. 

When Henry J. Kaiser set out to build The Grand Coulee Dam, he contacted Dr. Garfield to provide health care to 6,500 workers and their families at the largest construction site in history. Garfield turned the existing hospital into a state-of-the-art treatment facility and brought in other doctors to work in a “prepaid group practice.”

As the U.S entered World War II, about 30,000 workers poured into the Kaiser Shipyards in California, Oregon and Washington to work on Liberty Ships, aircraft carriers and other war related projects. Dr. Garfield, who was scheduled to enter active duty with his U.S. Army Reserve was released by President Roosevelt upon Kaiser’s request. He soon began setting up the comprehensive health care delivery system in the San Francisco Bay Area.

After the war ended the shipyard workforce fell from 90,000 to 13,000. Only 12 of 75 medical group providers remained. On July 21, 1945, the Permanente Health Plan opened to the public to continue the health care delivery set up by Kaiser and Garfield. In 10 years, more than 300,000 people enrolled in Northern California with the support of two unions, the International Longshoremen’s and Warehousemen’s Union and the Retail Clerks Union. 

In 1953, the name of the health plan and the hospitals was changed from Permanente to Kaiser Permanente. Even today, there are ties between the nonprofit Kaiser Foundation Health Plan and Hospitals and the Permanente Medical Groups. 

Kaiser Permanente Facts & Ratings

Year Founded 1945
Medicare Star Rating 5 stars (out of 5)
BBB Rating A+
NAIC Complaint Index 0.36% for group health

Kaiser Permanente Mobile App Rating

iOS
     3.1 2K users
Android
     4.3 16,728 users

The Kaiser Permanente app allows users to find doctors, hospitals, and pharmacies, view claims, and pay your bill. They also offer an app called Humana Pharmacy which helps you to manage your prescriptions.

Pros & Cons of Kaiser Permanente

  • Affordable marketplace plans with different tiers of coverage.
  • Low complaint ratio for group health plans.
  • Kaiser Permanente is only available in California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia and Washington D.C.

Kaiser Permanente Enrollment Process

Kaiser Permanente offers plans through the health insurance marketplace. You can begin searching plans here or you can get several free health insurance quotes here.

Each state has their own marketplace. If you’re not sure where to begin, visit https://www.healthcare.gov/. You can also schedule a personal appointment with a local Kaiser Permanente Medicare specialist: 1-866-973-4588.

How to file a claim with Kaiser Permanente

To submit claims for reimbursement, contact member services at 1-888-901-4636. Otherwise, you should be covered except for copay. If you need reimbursement for Medicare Part D prescriptions, you must use the Member reimbursement drug claim form (PDF). For all other prescriptions (non-Medicare and Medicare without Part D) you must use this Prescription claim form (PDF).

Common Questions about Kaiser Permanente

What is Kaiser Insurance?

Kaiser Permanente is a nonprofit, group-practice health plan with headquarters in Oakland, California. It is an example of high-quality, integrated health care.

Does Kaiser Permanente have good reviews?

Kaiser Permanente has a better than average complaint ratio, especially for it’s group plans.

Who is eligible for Kaiser Permanente?

Individuals, families and people whose employers offer Kaiser Permanente are eligible for coverage. Kaiser also offers Medicare Supplement plans and Medicare Advantage, which is the alternative to Original Medicare.

What pharmacies accept Kaiser Permanent’s health insurance?

If your health plan benefits include a prepaid prescription drug plan, you must use a Kaiser pharmacy to obtain drugs at plan prices. You can fill your initial prescription at many MedImpact pharmacies, which include Walgreens, CVS, Rite Aid, Kroger, Safeway and Costco, but you’ll need to order any refills through a Kaiser Permanente pharmacy or a mail order refill service through Kaiser.

Does Target Pharmacy accept Kaiser?

Target Pharmacy is now CVS, so yes, for an initial prescription you are covered. However, if your health plan benefits include a prepaid prescription drug plan, you must use a Kaiser pharmacy to obtain drugs at plan prices.

What states have Kaiser Insurance?

Kaiser Permanente is available in California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia and Washington D.C.

Who takes Kaiser Insurance?

To search for a doctor according to the insurance they accept visit here. There are over 8,000 internists and over 7200 family doctors and thousands of specialists who accept Kaiser Insurance.

What does Kaiser Permanente insurance cover?

Kaiser Permanente offers different coverages to different people, depending on the plan. Kaiser focuses on prevention as well as taking care of existing conditions. You can sometimes see a specialist without a referral from a primary care doctor.

How to check Kaiser coverage:

To see the status of your coverage or to see your benefits, sign onto kp.org. Select “Coverage & Cost” from the dashboard. Under “Plan Ahead” select “Eligibility and benefits.”

Does Kaiser Insurance cover ambulance?

Kaiser Permanente covers ambulance cost if the transportation is necessary or if a Kaiser Permanente physician or authorized staff member orders the ambulance or instructs the patient to call 911.

Does Kaiser cover therapists?

Kaiser offers mental health and wellness services with their basic plans, without charging extra.

How much is Kaiser Insurance?

In 2018, the average premium for single coverage was $575 per month or $6,896 per year. For a family, the average was $1,635 per month or $19,616 per year.

How to change Kaiser health insurance plans:

If you want to change an HMO plan to a PPO plan or vice versa, you’ll have to wait for the open enrollment period before the new year to make changes to your health plan, unless you have a qualifying event, which would enable you to make changes to your plan at any time during the year as long as it is within a reasonable time after a qualifying event.

Is it better to go with PPO or HMO with Kaiser?

Whether a PPO or HMO will serve you better depends on your needs and lifestyle. An HMO is a more economical choice than PPOs. However, to reap the financial benefit, you can only see in-network providers and may need to choose a primary care doctor to manage your health care and refer you to specialists within the network.

How to get a Kaiser Permanente health insurance quote:

You can compare health insurance quotes here.

Kaiser Permanente Contact Info

Address 1 Kaiser Plaza, Oakland, CA 94612
Phone 1 (510) 271-5910
Website https://healthy.kaiserpermanente.org/
Facebook https://www.facebook.com/kpthrive/
Youtube https://www.youtube.com/channel/UCqZdtT_o6xZbMkRbLZJ7Zvg
Twitter https://twitter.com/aboutKP
Linkedin https://www.linkedin.com/company/kaiser-permanente/

Methodology

The information listed on this page is from our own in house research. It is accurate as of the article publish date. Visit the carrier website for additional information.


How Does Kaiser Permanente to Other health Insurance Companies?

Kaiser Permanente vs Aetna Kaiser Permanente vs Anthem
Kaiser Permanente vs CareSource Kaiser Permanente vs HCSC
Kaiser Permanente vs Oscar Kaiser Permanente vs UnitedHealthcare

Compare Insurance Rates for Free.

Enter your zip code, answer a few questions, and compare rates in less than 3 minutes.