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Kaiser Bronze 60 HMO

Kaiser Bronze 60 HMO

Kaiser Bronze 60 HMO

In-Network
Cost Share Information 
Individual Deductible  $6,300
Family Deductible  $12,600
Out of Pocket Limit-Individual  $6,800 (including deductible)
Out of Pocket Limit-Family  $13,600 (including deductible)
Co-Insurance  100%
Lifetime Maximum  None
Office Visits 
Primary Care  $75 deductible waived for 1st 3 visits
Specialist  $105 deductible waived for 1st 3 visits
Adult Preventive Care  No Charge
Child Preventive Care  No Charge
Maternity Prenatal/Postnatal Care  No Charge
Rehabilitation Services  $75 deductible waived
Chiropractic Care  Not Covered 
Inpatient Services 
Inpatient Hospital 100% after deductible (up to OOP)
Maternity Delivery/Inpatient  100% after deductible (up to OOP)
Outpatient Services 
Outpatient Facility  100% after deductible (up to OOP)
Mental Health Outpatient  $75 deductible waived 1st 3 visits 

Lab

X-Ray 

Lab - $40 deductible waived

X-ray 100% after deductible 
Emergency Care 
Emergency Room  100% after deductible (up to OOP)
Urgent Care  $75 deductible waived 1st 3 visits 
Ambulance  100% after deductible (up to OOP)
Prescription Drugs 
Rx Deductible  $500 individual/$1000 family 
Rx Generic 

100% after deductible (up to OOP);

$500 max/script 
Rx Preferred 

100% after deductible (up to OOP);

$500 max/script 
Rx Non-Preferred 

100% after deductible (up to OOP);

$500 max/script 
Recovery/ Special Needs 
Home Health Care 

100% after deductible (up to OOP);

100 visits per year 
Durable Medical Equipment  100% after deductible (up to OOP)
 
Optional Benefits  None 

Complete Benefit Summary

If you you have questions about the Kaiser Bronze 60 HMO plan or any other plans from Kaiser Permanente of California please call The Lynn Company at (800)-326-5966 for more information on California Health Insurance Plans. 
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