The Traditional $10 Copay Plan provides access to comprehensive full-service medical care. Doctor and specialist visits are available for a $10 copay. Most preventative services are covered at no cost. Hospitalization, radiology, and lab tests are also covered at no cost. Prescription medication is covered at a copay range of $5 - $10. County of Sonoma, California, Human Resources, Benefits Unit.
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 |
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 |
- Kaiser Permanente's Medical Financial Assistance program helped pay for her medical care. Improving health care access for people with limited incomes and resources is fundamental to Kaiser Permanente’s mission. Our Medical Financial Assistance program helps low-income, uninsured, and underserved patients receive access to care.
- Premiums and services indicated in chart starting on page 2. Line only for company identifying information NW underwriting, MAS address I, KAISER PERMANENTE. Summary of Benefits and Coverage: What This Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after: 20 Copayment Coverage for.
- Kaiser Permanente. If you elect to participate in the Kaiser Permanente HMO plan, you are limited to using physicians and facilities that are part of Kaiser Permanente’s network of providers. All health care services (except for emergencies) must be coordinated.
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.
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 |
Kaiser Co Pay
Kaiser Permanente vs. Aetna: What You Need to Know
Kaiser Copay Plans
After the war ended the shipyard workforce fell from 90,000 to 13,000. Only 12 of 75 medical group providers remained. On July 21, 1945, the Permanente Health Plan opened to the public to continue the health care delivery set up by Kaiser and Garfield. In 10 years, more than 300,000 people enrolled in Northern California with the support of two unions, the International Longshoremen’s and Warehousemen’s Union and the Retail Clerks Union.
In 1953, the name of the health plan and the hospitals were changed from Permanente to Kaiser Permanente. Even today, there are ties between the nonprofit Kaiser Foundation Health Plan and Hospitals and the Permanente Medical Groups.
Kaiser Copay For Therapy
Aetna sold its group life and disability businesses to The Hartford for $1.45 billion. Aetna also responded to the hurricane season with donations exceeding $470,000 in Texas, Louisiana, and parts of the Caribbean. The company also matched donations from associates that totalled more than $230,000. Aetna is acquired by CVS Health Corporation at the end of 2017.
In 2018, The Aetna Foundation focused on the fight against the opioid epidemic in the U.S. Movavi video editor key activation. with grants totaling $6 million. In collaboration with U.S News & World News, the Aetna Foundation reveals the Healthiest Communities from 3,000 communities nationwide, across 10 categories.
Kaiser Copay Assistance
To learn more about each company, you can check out the Kaiser Permanente Overview and Aetna Overview.