Kaiser Permanente HMO
Kaiser Permanente HMO utilizes an integrated-care model where care is provided through their own doctors and facilities, including inpatient and outpatient settings, pharmacy, lab, imaging, and other ancillary services. Most services are covered at 100% after you pay your required copayment. Please refer to Evidence of Coverage documents for more information. To participate, you must live in one of the zip code service areas served by Kaiser Permanente HMO or Kaiser Permanente Senior Advantage HMO.
Visit Kaiser Permanente's SFHSS website here.
To compare medical plan benefits and see if Kaiser is right for you, click the buttons below.
The Kaiser Permanente HMO plan in Hawaii, Oregon, or Washington will end on December 31, 2026, and be replaced by the Blue Shield of California PPO plan with access to the national Blue Cross Blue Shield Association’s network. Beginning January 1, 2027, all Kaiser Permanente members outside of California will automatically be transitioned to the Blue Shield of California PPO plan, which will be the only available national medical plan option for SFHSS members who reside outside of California.
To learn more about Kaiser Permanente benefits, watch the Active Employee or Retiree Medicare videos below.
Find the Value in Your Benefits (Kaiser Permanente HMO Non-Medicare)
Discover more about the other options available to you by reviewing the Summary of Benefits in the plan documents. Below are some examples:
Out-of-Pocket Maximum
Individual: $1,500 / Family: $3,000
Hearing Aids
$2,500 allowance for each ear every 36 months
Routine Eye Exam
Rx Benefit Design
Rx Day Supply: Up to 100-day supply (not applicable to Tier 4 drugs)
Generic/Brand/Specialty Design
Tier 1: $5 (30-day) / $10 (100-day)
Tier 2: $15 (30-day) / $30 (100-day)
Tier 4: 20% / $100 (30-day)
Acupuncture and Chiropractic Services
Up to 30 combined visits per member, per calendar year, $15 co-pay per visit
2027 Kaiser Permanente HMO Non-Medicare Plan Documents
Find the Value in Your Benefits (Kaiser Permanente Senior Advantage HMO - Medicare Plan)
Discover more about the other options available to you by reviewing the Summary of Benefits in the plan documents. Below are some examples:
$1,000 Individual Out-of-Pocket Maximum
Limits your annual out-of-pocket costs for covered services.
Inpatient Hospital Care
One copay upon admission (Day 1), then $0 per day thereafter.
Skilled Nursing Facility
$0 for Days 1–100.
Telehealth
$0 copay for covered telehealth services.
Routine Eye Exams
Routine eye exams with a Plan Optometrist.
Routine Physical Exams
Coverage for routine physical exams.
Home Meal Delivery
Three meals per day for a consecutive four-week period, once per calendar year, following a hospitalization or skilled nursing facility stay.
Routine Transportation
Up to 24 one-way trips per calendar year, up to 50 miles per trip.
One Pass Fitness Benefit
Access to fitness and wellness resources through One Pass.
Prescription Drug Benefits
Up to a 100-day supply for eligible prescriptions.
Tier 1: $5 for a 30-day supply / $10 for a 100-day supply
Tier 2: $15 for a 30-day supply / $30 for a 100-day supply
2027 Kaiser Permanente Senior Advantage HMO Plan Documents
2026 Kaiser Permanente HMO Plan Documents
Kaiser Permanente Well-Being Benefit Highlights
- Kaiser Permanente Healthy Living
- Behavioral Health - call (800) 464-4000
- Kaiser Senior Advantage HMO OnePass
Additional Kaiser Permanente Senior Advantage Benefits
- Kaiser Permanente Senior Advantage Meals Benefit Flyer
- Kaiser Senior Advantage Non-Medical Transportation
Kaiser Permanente Disenrollment Form
Contact Kaiser Permanente
- Telephone: (800) 464-4000
- Website: choose.kaiserpermanente.org/sfhss
- Group Number:
- 888 (Northern California);
- 231003 (Southern California)