Kaiser WA plans
Kaiser WA offers four different medical plans which are available in the Puget Sound area: Kaiser WA Classic, Kaiser WA Value, Kaiser WA SoundChoice, and Kaiser WA CDHP. Another division of Kaiser Permanente also offers PEBB health plans which are only available in SW Washington and northern Oregon. This division is called Kaiser Permanente NW to distinguish it from the Puget Sound Kaiser WA plans.
Use the information on this page for help choosing the plan that’s best for you and your family. You can find step-by-step instructions for enrolling in benefits on the Integrated Service Center’s website.
In general, when you have a Kaiser WA plan, you’ll visit Kaiser Permanente Medical Centers to receive care and get prescriptions. Kaiser Permanente has locations throughout Puget Sound and encompasses a wide array of doctors and other professionals. However, you don’t receive coverage if you use a provider outside the plan’s network.
To browse each plan’s network or to find a specific provider, either call the plan directly or use the plan’s web search tool.
|Plan||Network||Find a provider online|
|Kaiser WA CDHP||Core||CDHP network search|
|Kaiser WA Classic||Core||Classic plan network search|
|Kaiser WA SoundChoice||PEBB SoundChoice||SoundChoice network search|
|Kaiser WA Value||Core||Value plan network search|
Copayments or coinsurance?
With coinsurance, the costs you pay for services are calculated as a percentage (for example, 20 percent). Insurance pays the remaining percentage of the cost. With copayments, on the other hand, you pay a fixed amount (for example, $20).
Generally, you’ll pay coinsurance after your visit the doctor, when the bill arrives in the mail. Copayments are usually made at the doctor’s office, when you receive the service.
While plans using coinsurance are more common, some people prefer plans with copayments because costs are more predictable.
|Primary care visit
|Kaiser WA Classic||$167||$175||$15 copayment|
|Kaiser WA Value||$94||$250||$30 copayment|
|Kaiser WA SoundChoice||$46||$125||0% coinsurance|
|Kaiser WA CDHP||$25||$1500||10% coinsurance|
Complete table of Employee monthly medical premiums 2023
While all plans cover the same basic health care services, you may want to know whether or not a certain service is covered by the plan. The most direct way to find out is to call the plan and ask. Alternatively, you can read the plan’s Certificate of Coverage (also called the benefits booklet), which describes the plan in detail. These booklets are long, but they can be helpful if you need to know something specific.
If you simply want an overview of a plan’s coverage and costs, take a look at the plan Summary of Benefits and Coverage, an easy-to-read summary that lets you quickly review health plans. You can compare options based on price, benefits, and other features that may be important to you.
To view plan details side by side and directly compare coverage and costs, use the state’s medical benefit comparison tool.
2023 plan summaries
|Plan||Certificate of Coverage (2023)||Summary of Benefits
and Coverage (2023)
|Kaiser WA CDHP||View PDF||View PDF|
|Kaiser WA Classic||View PDF||View PDF|
|Kaiser WA SoundChoice||View PDF||View PDF|
|Kaiser WA Value||View PDF||View PDF|
Prescription drug coverage
With Kaiser Permanente, you’re required to use network pharmacies for prescription drugs; otherwise, you’ll pay full price for prescriptions. There is a deductible for prescriptions with the Kaiser Permanente Classic, SoundChoice, and Value plans. This deductible does not apply to value or tier prescriptions. Mail-order drugs are available in all plans.
Coverage is tiered: the amount you pay increases as you move up the tiers from the least expensive, generic drugs, to the more expensive, specialty drugs.
You can find complete details about prescription drug coverage by reviewing the plan’s Certificate of Coverage.
Vision benefits are part of your medical plan. Providers can be found in the provider directory, or by contacting the medical plan.
Plan ID Cards
After you enroll, your health plan will send you an identification (ID) card to show to providers when you receive care. If you have questions about your ID card, contact your plan directly.