What were the main Kaiser Permanente plans available in 2018
In 2018, Kaiser Permanente offered a range of managed care plans built around an integrated model that combined coverage, care delivery, and a closed network of physicians and hospitals. These plans generally fell into several categories: Medicare Advantage, employer-sponsored group plans, and individual market options offered in states that used Covered California. Some regional plans were also available, such as Kaiser Foundation Health Plan in Northern and Southern California and Kaiser Hawaii plans for members living in or near those markets. Across these offerings, members typically accessed care through the Kaiser Permanente network, using a coordinated system that emphasized preventive services, primary care gatekeeping, and electronic health records.
How Kaiser Permanente plans are organized and who they serve
Kaiser Permanente functions as both an insurance plan and a health care delivery system in certain regions, operating licensed health plans in multiple states alongside a large clinical group. For members looking for Kaiser Permanente plans 2018 details, the basics include plan types and options based on eligibility: some plans are available through employers, others through Medicare or the individual marketplace. In states like California and Hawaii, Kaiser plans were commonly available as employer-group coverage or individual plans through Covered California. Plans are typically identified by regional variations, such as Kaiser Foundation Health Plan of the Northwest or the Northern California Division, but all operate under a similar coordinated care model.
Eligibility and access basics
Eligibility in 2018 depended on the specific product and state. Group plans required employment with a participating employer, Medicare plans required age 65 or older eligibility for Medicare, and individual plans required enrollment during applicable open enrollment or qualifying events. Provider networks were largely closed, meaning members received the lowest cost sharing when using Kaiser Permanente doctors and facilities, although some plans offered limited out-of-network coverage at higher cost.
Cost-sharing and premiums for 2018 Kaiser Permanente plans
Premiums, deductibles, copayments, and coinsurance varied by plan and location, but the overall structure emphasized lower costs for in-network care. Members typically paid monthly premiums plus deductibles that reset annually, with copays for primary care, specialist visits, and emergency care. Prescription drug cost-sharing was included in most plans, with tiers for preferred and nonpreferred medications. The following table summarizes indicative ranges seen in major Kaiser plans offered in 2018.
| Plan type | Membership in 2018 (approximate) | Monthly premium range (USD) | Deductible example (individual, USD) | Copay primary care (USD) |
|---|---|---|---|---|
| Employer group HMO | 10M+ members across all Kaiser entities in 2018 | Varies by employer contribution | Low or zero-dollar deductibles common | $10–$45 |
| Medicare Advantage HMO | Hundreds of thousands nationally | $0–$150+ depending on plan and subsidies | $0–$6,350 plan-dependent | $0–$70 |
| Individual HMO (Covered California 2018) | Tens of thousands | $300–$600+ | $2,500–$6,350 | $20–$45 |
Network characteristics and how care coordination works
Kaiser Permanente is known for its tightly integrated delivery system in many markets, which in 2018 meant that members were encouraged to receive care within the organization’s own facilities and providers. Primary care physicians generally served as gatekeepers for specialty care, and the health system’s investment in electronic health records supported care coordination across locations. Because the model relies on a closed or predominantly closed network, out-of-network coverage was either very limited or provided at a higher cost-sharing level, depending on the specific plan and state regulations.
Key considerations when comparing plans in 2018
When evaluating Kaiser Permanente options, several factors stood out in 2018: the extent of the provider network in a given region, whether the plan was offered through an employer or purchased individually, subsidy eligibility in Covered California markets, and the level of integration between care delivery and insurance. Members who preferred a wide choice of out-of-network providers might find Kaiser less suitable, while those who valued coordinated care and lower out-of-pocket costs for in-network services often found the structure advantageous. Prescription drug formularies and prior authorization requirements also varied, so reviewing plan-specific drug lists was important.
Special notes for specific markets
Kaiser Foundation Health Plan Northern California
In the San Francisco Bay Area and other parts of Northern California, the Kaiser Foundation Health Plan served a large and stable member base through a mix of employer-group and Covered California individual plans in 2018.
Kaiser Foundation Health Plan Southern California
Southern California operations provided similar coordinated care with some regional plan variations, including employer-only or public option mixes depending on eligibility.
Kaiser Hawaii plans
Hawaii members could access Kaiser plans where available, with features aligned with the organization’s coordinated care model, including preventive emphasis and relatively low cost sharing within the network.
Frequently asked questions about Kaiser Permanente plans in 2018
- What types of plans did Kaiser offer in 2018? In 2018, Kaiser Permanente offered employer-sponsored group HMO plans, Medicare Advantage HMO plans, and individual market HMOs in states such as California through Covered California.
- Were Kaiser plans available in all states in 2018? No. Kaiser Permanente operated licensed health plans primarily in California, Hawaii, Oregon, Washington, Colorado, and parts of the Mid-Atlantic region in 2018.
- Could I keep my doctor on a Kaiser plan in 2018? Members typically received the lowest cost sharing when using providers within the Kaiser Permanente network; out-of-network coverage was limited or costly, depending on the plan.
- Did Kaiser Permanente have prescription drug coverage in 2018? Yes. Most plans included a Medicare Part D equivalent or integrated pharmacy benefit with tiered copays and prior authorization for certain medications.
- How do premiums compare to other major plans in 2018? Premiums varied widely by employer contribution and plan type, but many employer-based Kaiser plans were competitive in total cost of ownership due to lower deductibles and copays for in-network care.
Takeaway
In 2018, Kaiser Permanente plans were structured around a coordinated care model that emphasized in-network care, preventive services, and closed provider networks. Costs were generally predictable through employer group subsidies or standardized individual pricing, with notable regional variations. Members considering these plans needed to weigh network breadth, out-of-network limitations, and plan-specific benefits such as drug formularies and subsidy eligibility.