As you transition to civilian life, shopping for health care can be confusing. But it’s an important and necessary decision. You don’t want to pay too much for care you don’t need or too little for care that doesn’t protect you. You want to make the right choice for you and your family’s health.
Kaiser Permanente is here to help make this important decision an easy one. We designed this page as your complete resource for health care and coverage, with everything you need to know.
Watch for a quick overview of how a health care plan works, key health care terminology, and some considerations for choosing a plan.
Medical services are often very expensive, which can make it hard to afford regular care and budget for emergencies. Instead, you can make small upfront payments for health insurance, which will then cover a significant portion of your medical expenses when necessary.
Health insurance has two key elements: health care and health coverage.
Everyone gets sick or injured occasionally. Health care is the actual services provided by medical professionals who diagnose, treat, and help prevent medical issues. These services include:
Health insurance is a contract between you and an insurer, known as health care coverage or your health care policy. The contract stipulates:
You pay a monthly premium to your insurer in exchange for health coverage for medical services.
Your insurer pays for a portion of your medical services.
A network of hospitals, doctors, and other health care providers who agree to provide medical services within the network in exchange for a certain payment rate. With few exceptions, you must access care within the HMO network.
A health plan that contracts with hospitals, doctors, and other health care providers to create a flexible network of participating providers. You may access care inside or outside the network. In-network care is usually priced similarly to an HMO, while out-of-network care is more expensive in exchange for flexibility.
HMO vs. PPO — How do they compare?
Generally lower monthly premiums and out-of-pocket costs.
Generally higher monthly premiums and out-of-pocket costs. You usually need to pay the full cost of medical services until you reach your plan deductible, after which your health insurance begins contributing.
You pay a monthly premium. Your doctor earns a salary instead of being paid per service.
You pay a fee for each service.
You select a primary care physician who manages your care within the HMO network.
You select your own primary care physician from inside or outside the network and manage your own care, which includes carrying information, test results, etc., from doctor to doctor.
You can only see contracted providers inside the HMO network, except in emergencies.
You can see providers inside or outside the PPO network. Your costs are usually lower inside the network.
You may need a referral from your in-network primary care physician to see specialists.
No referral required to see specialists.
Now that you understand health insurance better, we’d like to explain why we’re the right choice for you. Kaiser Permanente is an alliance between Kaiser Foundation Health Plans and their respective Permanente Medical Groups — in other words, an alliance between health care and coverage. We combine them into our complete integrated care system, which operates more cohesively and efficiently than traditional health insurance.
In the traditional PPO model, health insurance and health care are separate entities with competing agendas. Providers charge per service and profit from you accessing as many services as possible.
Our HMO-based system puts care and coverage on the same team, with one common goal: your health. Your doctor is paid a salary to care for you, regardless of how many services you access, and you make decisions together without interference from an insurance company. This eliminates redundant and expensive services, frees you from having to manage your own care, and creates better health outcomes for you.
The healthier you are, the lower your health care costs will be. When comparing health plans, look for tools and services that make it easy to access care and live healthier overall.
Your Kaiser Permanente’s health coverage includes easy ways to stay healthy — most at no additional cost:
Convenient care access
Our innovative suite of care access options allow you to get treated how, when, and where you need it.
Healthy lifestyle programs
We offer personalized, online programs to help you create an action plan to reach your health goals.
Fitness deals
Stay active and fit with a variety of reduced rates on studios, gyms, fitness gear, and online classes — just for Kaiser Permanente members.
Self-care apps
Our wellness apps can help you navigate life’s challenges, improving your sleep, mood, relationships, and more for total health.
Personal wellness coaching
Get one-on-one guidance and support from a dedicated wellness coach who can help you set goals, stick to them, and, most importantly, see results.
Federal & Postal employees
800-514-3480 (TTY 711)
Monday – Friday, 10 a.m. – 9 p.m.
Civilians
800-514-3475 (TTY 711)
Monday – Friday, 10 a.m. – 9 p.m.
Kaiser Permanente health plans around the country: Kaiser Foundation Health Plan, Inc., in Northern and Southern California and Hawaii • Kaiser Foundation Health Plan of Colorado • Kaiser Foundation Health Plan of Georgia, Inc., Nine Piedmont Center, 3495 Piedmont Road NE, Atlanta, GA 30305, 404-364-7000 • Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc., in Maryland, Virginia, and Washington, D.C., 4000 Garden City Drive, Hyattsville, MD 20785 • Kaiser Foundation Health Plan of the Northwest, 500 NE Multnomah St., Suite 100, Portland, OR 97232 • Kaiser Foundation Health Plan of Washington or Kaiser Foundation Health Plan of Washington Options, Inc., 1300 SW 27th St., Renton, WA 98057
Adobe Acrobat is required to read PDFs.
