A deductible is an amount you pay for healthcare before your insurance starts to pay. If you’ve met your deductible, you’ll only owe your copay at the time of your urgent care visit. The typical copay at urgent care is between $25 and $75, though this depends on your. .If you receive urgent or emergency care outside of a Kaiser facility, please call the Kaiser number listed on the back of your ID card. View a comparison of the medical plans on the 2021 At-a-Glance. Log into your Kaiser account to schedule appointments, email your doctor, have a video visit, and find resources to support your entire.
This is a comparison of the copay medical plans for FY 2019-20 open enrollment. Please see the High Deductible Health Plan Comparison page as well.
| United Healthcare (UHC) Copay Choice Plus Plan | Kaiser Permanente (KP) DHMO Plan | ||||
|---|---|---|---|---|---|
| Annual Deductible | Network | Non-Network | Annual Deductible | Network | Non-Network |
| Individual | $1,500 | $3,000 | Individual | $750 | Not Covered |
| Family | $3,000 | $6,000 | Family | $1,500 | |
Kaiser Urgent Care Riverside
| Annual Out-of-Pocket Max: UHC | Annual Out-of-Pocket Max: KP | ||||
|---|---|---|---|---|---|
| Annual Deductible | Network | Non-Network | Annual Deductible | Network | Non-Network |
| Individual | $5,000 | $10,000 | Individual | $2,000 | Not Covered |
| Family | $10,000 | $20,000 | Family | $4,000 | |
| Co-Insurance: UHC | Co-Insurance: KP | ||||
|---|---|---|---|---|---|
| Annual Deductible | Network | Non-Network | Annual Deductible | Network | Non-Network |
| Percentage you pay after you have satisfied your deductible. | 20% | 50% | Percentage you pay after you have satisfied your deductible. | 10% | Not Covered |
| Office Visits/Urgent Care (1): UHC | Office Visits/Urgent Care (1): KP | ||||
|---|---|---|---|---|---|
| Service | Network | Non-Network | Service | Network | Non-Network |
| Preventative Care/Screenings | No Charge | 50% of eligible expenses after deductible | Preventative Care/Screenings | No Charge | Not Covered |
| Primary Care - Illness/Injury | $30 Copay | Primary Care - Illness/Injury | $30 Copay | ||
| Specialist | $50 Copay | Specialist | $50 Copay | ||
| Inpatient Hospital | 20% Co-insurance after $1,000 Copay | Inpatient Hospital | 10% Coinsurance | ||
| Urgent Care | $75 Copay | Urgent Care | $75 Copay | ||
| Ambulance | 20% after deductible | Ambulance | $500 Copay | ||
| Emergency Room | $500 Copay | Emergency Room | |||
| Virtual Visits (Network Benefits are available only when services are delivered through a Designated Virtual Network Provider.) | $30 Copay | Not Covered | Virtual Care - Primary/Specialty - Phone Visit, Video Visit - Chat Online, Email, E-visits | No Charge | Not Covered |
| Mental Health (1): UHC | Mental Health (1): KP | ||||
|---|---|---|---|---|---|
| Service | Network | Non-Network | Service | Network | Non-Network |
| Inpatient (Hospitalization/Day Treatment) | 20% Co-insurance after $1,000 Copay | 50% of eligible expenses after deductible | Inpatient (Hospitalization/Day Treatment) | 10% Coinsurance | Not Covered |
| Outpatient (Therapy) | $30 Copay | Outpatient (Therapy) | $30 Copay | ||
| Substance-Related & Addictive Disorders Services (1): UHC | Substance-Related & Addictive Disorders Services (1): KP | ||||
|---|---|---|---|---|---|
| Service | Network | Non-Network | Service | Network | Non-Network |
| Inpatient | 20% Co-insurance after $1,000 Copay | 50% of eligible expenses after deductible | Inpatient | 10% Coinsurance | Not Covered |
| Outpatient (Therapy) | $30 Copay | Outpatient (Therapy) | $30 Copay | ||
| Vision: UHC | Vision: KP | ||||
|---|---|---|---|---|---|
| Service | Network | Non-Network | Service | Pediatric (up to end of month he/she turns age 19) | Adult (members age 19 and over) |
| Up to 1 Routine Exam per plan year under the Medical Plan | $50 Copay | - Allowances apply to network providers only. - Please refer to your plan details for out-of-network allowances | Optometrist/ Ophthalmologist | Optometrist: $30 Copay/ Ophthalmologist: $50 Copay (Includes contact lens fitting up to $175) | |
| Optical hardware | - Frames $130 allowance OR - Contact lens $150 allowance | Optical hardware | - 10% Coinsurance - 1 pair of glasses & lenses every 2 years or 2 years of contact lenses | $150 Credit once every 24 months towards optical hardware | |
| Prescription: UHC | Prescription: KP (2) | ||||
|---|---|---|---|---|---|
| Retail: 30-day supply | Mail Order: 90-day supply | Retail: 30-day supply | Mail Order: 90-day supply | ||
| Tier 1 | $10 Copay | $20 Copay | Generic | $10 Copay | $20 Copay |
| Tier 2 | $30 Copay | $60 Copay | Preferred Brand Name | $30 Copay | $60 Copay |
| Tier 3 | $50 Copay | $100 Copay | Non-Preferred Brand Name | Approved drugs covered at generic costshare | |
| Specialty (30 day supply) | 20% up to $100 | Specialty | 20% up to $100 | ||
* Please refer to the official plan documents for detailed information and listing of covered services
- If a procedure is preformed during a Primary Care, Specialty Care, or Urgent Care Visit then the service is covered at coinsurance after deductible is met.
- For Southern Colorado Kaiser Permanente members: maintenance medications must be filled at a Pharmacy in a Kaiser Permanente medical office or through Kaiser Permanente mail order.
Kaiser Urgent Care Near Me
Rates - Employee Monthly Contribution
| United Healthcare Copay Choice Plus Plan | Kaiser Permanente DHMO Plan | ||
|---|---|---|---|
| Employee Only | $159.14 | Employee Only | $93.72 |
| Employee + Spouse | $437.52 | Employee + Spouse | $298.02 |
| Employee + Child(ren) | $310.30 | Employee + Child(ren) | $190.34 |
| Family | $638.86 | Family | $440.48 |