About Kaiser Permanente
Founded in 1945 in Oakland, California, Kaiser Permanente serves members in the District of Columbia and eight states:
- California
- Colorado
- Georgia
- Hawaii
- Maryland
- Oregon
- Virginia
- Washington
Kaiser Permanente, which can also be called Kaiser Foundation Health Plan depending on the location, is one of the biggest not-for-profit health plans in the U.S.
Kaiser Permanente says it offers a unique care model in which connected teams of experts collaborate across departments and specialties. The company says this promotes speedier diagnosis, treatment and recovery.
It offers health maintenance organization and exclusive provider organization plans on the health insurance marketplace and is one of the best health insurance companies in our analysis.
When Can You Buy a Kaiser Permanente ACA Plan?
Open enrollment to buy a health plan on the ACA marketplace is from Nov. 1 to Jan. 15 every year in most states. Some states have slightly different open enrollment periods.
During open enrollment in your state you can buy an ACA plan or make changes to current coverage. The only way to buy an ACA plan outside of this period is if you have a qualifying life event for a special enrollment period. This includes changes like getting married, having a baby, moving or aging out of a parent’s plan when you turn 27.
Types of Health Insurance Offered by Kaiser Permanente
In addition to its Affordable Care Act (ACA) plans available on HealthCare.gov, Kaiser Permanente offers:
- Individual and family health insurance
- Medicaid, including Medi-Cal
- Medicare
- Employer-sponsored health insurance
Types of Health Plans Available from Kaiser Permanente
Kaiser Permanente offers two types of plans on the health insurance marketplace:
- HMO: Patients with a health maintenance organization (HMO) plan typically only are covered for care from providers within the plan’s network. In most cases, you need a referral to see a specialist.
- EPO: An exclusive provider organization (EPO) plan is similar to a HMO. You have to stay in the plan’s provider network to get covered, but you don’t have to get a primary care provider referral to see a specialist.
Insurers can offer up to four metal tiers on the ACA marketplace: bronze, silver, gold and platinum. Kaiser Permanente provides all metal tiers, but you may have trouble finding a platinum option. Bronze plans have the lowest premiums but the highest deductibles and out-of-pocket costs. Platinum plans have the highest premiums but lowest out-of-pocket costs.
Where Is Kaiser Permanente Health Insurance Available?
Member Benefits from Kaiser Permanente
Kaiser Permanente offers several types of perks with its health insurance plans. They include:
- Free access to the Calm app, which helps you use meditation and mindfulness to build mental resilience, reduce stress and improve sleep.
- Free access to Headspace Care, an app that offers 24/7 text-based emotional support coaching.
- Healthy lifestyle programs, such as online programs to help you lose weight, quit smoking and reduce stress.
- One-on-one phone consultations with a wellness coach.
- Reduced rates on acupuncture, massage therapy and chiropractic care.
- Reduced rates on gym memberships and digital workout videos.
Not all benefits are available in all markets.
How Much Do Kaiser Permanente Health Insurance Plans Cost?
Kaiser Permanente health insurance plans cost $570 monthly on average for an ACA marketplace plan. Age is one cost factor for ACA plans. Costs for Kaiser’s ACA plans range from $382 for a 21-year-old to $1,036 for a 60-year-old.
Average Kaiser Permanente Health Insurance Cost by Age
Age of member | Average monthly costs for a Kaiser Permanente plan |
---|---|
Age 21 | $382 |
Age 27 | $400 |
Age 30 | $433 |
Age 40 | $488 |
Age 50 | $682 |
Age 60 | $1,036 |
ACA marketplaces are divided by metal tier: bronze, silver, gold and platinum based on premiums and out-of-pocket costs.
Bronze and silver plans have the lowest upfront costs but the most out-of-pocket costs when you need healthcare. Platinum and gold have higher premiums but fewer out-of-pocket costs. Bronze and silver plans are the most common type of plan, while platinum plans are fairly rare.
Average Costs for Kaiser Permanente by Metal Plan
Age of member | Average monthly cost for a Kaiser Permanente bronze plan | Average monthly cost for a Kaiser Permanente silver plan | Average monthly cost for a Kaiser Permanente gold plan | Average monthly cost for a Kaiser Permanente platinum plan |
---|---|---|---|---|
Age 21 | $314 | $406 | $425 | $480 |
Age 27 | $329 | $426 | $446 | $503 |
Age 30 | $357 | $461 | $483 | $544 |
Age 40 | $402 | $519 | $544 | $613 |
Age 50 | $561 | $726 | $760 | $856 |
Age 60 | $853 | $1,103 | $1,154 | $1,301 |
How Kaiser Permanente Costs Compare to Other Companies
Kaiser Permanente ACA marketplace plans are cheaper, on average than some competitors analyzed by Forbes Advisor.
Average Monthly Costs for ACA Marketplace Plans by Company
Age of member | Kaiser Permanente | Aetna | Blue Cross Blue Shield | UnitedHealthcare |
---|---|---|---|---|
Age 21 | $382 | $396 | $445 | $434 |
Age 27 | $400 | $419 | $467 | $454 |
Age 30 | $433 | $452 | $506 | $492 |
Age 40 | $488 | $508 | $569 | $554 |
Age 50 | $682 | $711 | $796 | $775 |
Age 60 | $1,036 | $1,078 | $1,209 | $1,177 |
HMOs: Average Monthly Health Insurance Costs
Company | Age 21 | Age 27 | Age 30 | Age 40 | Age 50 | Age 60 |
---|---|---|---|---|---|---|
Kaiser Permanente | $389 | $408 | $442 | $497 | $695 | $1,056 |
$392 | $415 | $448 | $503 | $704 | $1,067 | |
$401 | $420 | $455 | $512 | $716 | $1,088 | |
$385 | $403 | $437 | $492 | $687 | $1,044 | |
$467 | $489 | $530 | $596 | $834 | $1,267 | |
Molina Healthcare | $407 | $432 | $466 | $524 | $733 | $1,110 |
$374 | $392 | $425 | $479 | $669 | $1,016 | |
$425 | $445 | $482 | $543 | $758 | $1,152 |
EPOs: Average Monthly Health Insurance Costs
Company | Age 21 | Age 27 | Age 30 | Age 40 | Age 50 | Age 60 |
---|---|---|---|---|---|---|
Kaiser Permanente | $364 | $381 | $413 | $465 | $650 | $987 |
$408 | $427 | $463 | $521 | $728 | $1,107 | |
$423 | $443 | $480 | $540 | $755 | $1,147 | |
$463 | $488 | $528 | $593 | $830 | $1,259 | |
$413 | $434 | $470 | $529 | $739 | $1,122 | |
$418 | $438 | $474 | $534 | $746 | $1,134 | |
$450 | $471 | $510 | $575 | $803 | $1,221 |
Featured Health Insurance Partners
1
Aetna
Offers plans in all 50 states and Washington, D.C.
About 1.2 million
$20
2
Blue Cross Blue Shield
Offers plans in all 50 states and Washington, D.C.
About 1.7 million
$10
3
Cigna
Offers plans in all 50 states and Washington, D.C.
About 1.5 million
$0
Reviews & Ratings for Kaiser Permanente
Kaiser Permanente has one of the lowest complaint levels among the companies we reviewed. This is a sign of high customer satisfaction and few problems with claims..
Other ratings for Kaiser Permanente include:
- Average National Committee for Quality Assurance: 4.3 out of 5 stars
- Fitch Ratings Insurer Default Rating: AA- (Stable)
Kaiser Permanente received the highest average NCQA score of the health insurance companies that we analyzed. One of those plans—an HMO offered in Maryland, Virginia and Washington, D.C.—received five stars, which is the highest mark.
That commercial HMO plan offered by Kaiser Foundation Health Plan received 5 out of 5 stars for prevention and equity, which included immunizations, women’s reproductive health, cancer screening and other preventive measures. It also received 4.5 out of 5 stars for treatment but only 2.5 for patient experience.
Fitch Ratings gave the company an AA- for its Insurer Default Rating. Fitch Ratings praised the nonprofit company’s “very strong financial profile” and “very strong absolute levels of net adjusted debt (cash and investments in excess of debt and debt equivalents.”
Compare the Best Health Insurance Companies
Methodology
We analyzed 96 data points about coverage and quality to identify the best health insurance companies. Our ratings are based on:
- Average premiums (30% of score): We took the average Affordable Care Act health insurance marketplace rates for the following ages: 21, 27, 30, 40, 50 and 60, and then came up with an overall average. Source: HealthCare.gov.
- Complaints made to state insurance departments (30% of score): We used complaint data from the National Association of Insurance Commissioners.
- Average silver plan deductible (20% of score): The deductible is how much you have to pay for healthcare in a year before the health plan begins picking up a portion of the costs. Companies with health plans that had low deductibles got more points. Source: HealthCare.gov.
- Breadth of health plans (10% of score): Health insurance companies may offer up to four types of plan benefit designs (PPO, HMO, EPO and POS). We gave companies that offered more types of plans more points. Source: HealthCare.gov.
- Metal tier offerings (10% of score): The ACA marketplace has four metal tier levels. We gave points to companies that offered more tier plan options. Source: HealthCare.gov.
Read more: How Forbes Advisor rates health insurance companies