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Cover employees inside and out with Kaiser Permanente Plus™

Out of network? You’re in luck. KP Plus combines access to doctors and medical centers at Kaiser Permanente with the flexibility to see out-of-network providers. It's a health plan that enhances employee well-being and choice, while simplifying administration.

Learn more about KP Plus

Discover how KP Plus can benefit your employees and your organization.

Learn more
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How do we offer high-quality care?

Through our unique care-and-coverage model, payers and providers work together to prioritize health outcomes for patients. This means less time and money on unnecessary tests or treatments and an emphasis on preventive and proactive care – translating to a healthier workforce and savings for your company in the long run. It’s no wonder Kaiser Permanente is among the highest-rated health plans in every state we serve.1

A doctor checking a patient’s ear

The best of both worlds

With KP Plus, not only do employees benefit from our true value-based care, but they also have the flexibility to keep their favorite out-of-network doctors. They can have a set number of physician visits or outpatient medical services annually without the need for referrals or prior authorization, as well as a set number of prescription fills or refills at the pharmacy of their choice.

A doctor checking a patient’s ear

Care that meets employee needs

Learn more about the plan that balances choice with access to our unique care-and-coverage model.

World-class care plus ease and flexibility

Offer a health plan that makes your company a competitive and desirable place to be, with the added simplicity of working with one provider for all your employee health benefit needs.

  • Band aid icon

    Patient-centered
    care

  • Info icon

    High-value
    provider access

  • Dollar icon

    Simplified
    administration

High-quality care. Out-of-network flexibility.

In today's health care landscape employers want solutions that balance affordability, provider flexibility, and quality care.

KP Plus uniquely addresses these needs through:

  • Ten covered out-of-network services and five prescription refills annually without referrals
  • Convenient, all-under-one-roof access to high-quality care
  • Generally lower monthly rates compared to typical PPO plans
  • A focus on accessible, often $0 copay preventive services that reduce chronic conditions and higher-cost treatments

Our members are:

33%

less likely to experience premature death due to heart disease2

20%

less likely to experience premature death due to cancer3

50%

more likely to avoid costly ER or urgent care visits by using our 24/7 virtual care for a video visit4

KP Plus sample plan benefit and costs

The plan’s straightforward design, with clear cost shares and a transparent breakdown of costs, empowers your employees to make informed health care decisions. Preventive care — the key to staying healthy — is covered at no cost, whether they choose in-network or out-of-network providers.

 

Please note that this is a sample plan design.

Benefit In-network care
 Out-of-network care
Deductible (individual/family)
 $2,000/$4,000 n/a
Out-of-pocket maximum (individual/family) $4,000/$8,000
 n/a5
Preventive care
 $0
 $0
Virtual care
$0
 $20
Primary care office visit
 $20
 $40
Specialty care office visit
 $30
 $50
Mental health office visit $20 $40
Physical therapy
 $30 $50
Lab $15 $35
X-ray $20 $40
Emergency care 20% coinsurance 20% coinsurance
Inpatient hospital services 20% coinsurance (after deductible is met) Not covered
Prescription drugs (generic/brand-name/nonpreferred6/specialty7) $5/$15/$35/20% up to $200 $25/$35/$55/30%
Benefit
: 
In-network care
Deductible (individual/family)
$2,000/$4,000
Out-of-pocket maximum (individual/family)
$4,000/$8,000
Preventive care
$0
Virtual care
$0
Primary care office visit
$20
Specialty care office visit
$30
Mental health office visit
$20
Physical therapy
$30
Lab
$15
X-ray
$20
Emergency care
20% coinsurance
Inpatient hospital services
20% coinsurance (after deductible is met)
Prescription drugs (generic/brand-name/nonpreferred6/specialty7)
$5/$15/$35/20% up to $200
Benefit
: 
Out-of-network care
Deductible (individual/family)
n/a
Out-of-pocket maximum (individual/family)
n/a5
Preventive care
$0
Virtual care
$20
Primary care office visit
$40
Specialty care office visit
$50
Mental health office visit
$40
Physical therapy
$50
Lab
$35
X-ray
$40
Emergency care
20% coinsurance
Inpatient hospital services
Not covered
Prescription drugs (generic/brand-name/nonpreferred6/specialty7)
$25/$35/$55/30%

Ready to transform your employee benefits? Click below or call (866) 798-9842

Footnotes:

  • 1 NCQA’s Private Health Insurance Plan Ratings 2024–2025, National Committee for Quality Assurance, 2024: Kaiser Foundation Health Plan of Colorado — HMO (rated 4 out of 5); Kaiser Foundation Health Plan of Georgia, Inc. — HMO (rated 4 out of 5); Kaiser Foundation Health Plan, Inc., of Hawaii — HMO (rated 4 out of 5); Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. — HMO (rated 5 out of 5); Kaiser Foundation Health Plan, Inc., of Northern California — HMO (rated 4.5 out of 5); Kaiser Foundation Health Plan of the Northwest — HMO (rated 4 out of 5); Kaiser Foundation Health Plan, Inc., of Southern California — HMO (rated 4.5 out of 5); Kaiser Foundation Health Plan of Washington — HMO (rated 4.5 out of 5). Continue at [1]

  • 2 McGlynn et al., "Measuring Premature Mortality Among Kaiser Permanente Members Compared to the Community," July 20, 2022. Continue at [2]

  • 3 See note 2. Continue at [3]

  • 4 Kaiser Permanente 2022 Annual Report. Continue at [4]

  • 5 In California, charges from out-of-network providers or pharmacies count toward the out-of-pocket maximum. Continue at [5]

  • 6 Nonpreferred prescriptions do not apply in California and follow the same copay as brand-name prescriptions. Continue at [6]

  • 7 Out-of-network coverage for specialty drugs varies by plan and service area. Continue at [7]