Individual and Family Plans
Of the three options, these plans are oftentimes the lowest-priced option. There is an exception. If you worked for a large company (50 or more employees), then sometimes, a COBRA plan could be lower priced. Unlike group insurance, which usually offers a single one-size-fits all plan, Individual and Family Plans allow you to match the benefits and price to your needs. Individual and Family Plans are ideal for persons who have no, or minor, medical conditions. Eligibility is subject to medical underwriting, so enrollment is not guaranteed. If approved, however, you can stay on the Individual and Family Plan indefinitely; it’s not tied to your employment. Coverage is month-to-month, so if you wish you can cancel the insurance when your new employer’s plan kicks in. Individual and Family Plans are often the best option for people who are in-between jobs.

COBRA
If you need a plan that does not require medical underwriting, then you might consider COBRA. COBRA allows you to temporarily keep the same benefits that you had on your group insurance. The premium will be the amount you paid plus the amount subsidized by the employer. If you work for a large company, there is also an administration fee. New legislation may make COBRA a more affordable option than before. For information about the COBRA premium subsidy program, visit the Department of Labor’s website. Note: If the company has gone out of business, COBRA is not an available option.

Conversion
If you need a plan that does not require medical underwriting or the company has been dissolved, the Conversion or HIPAA (Health Insurance Portability and Accountability Act of 1998) Plan may be your only viable option. Conversion allows you to convert your existing group insurance into an individual plan. The benefits will not be the same as what you had under your group insurance and the cost will probably be more expensive, approximately 170% of Kaiser Permanente Individuals and Families Plan rates. The advantage of a Conversion Plan is that you won’t be denied for pre-existing conditions. To qualify, you must meet all of the following five requirements:
1. You must have at least 18 months of creditable coverage without a break in coverage of more than 63 days at any time.
2. Your most recent health care coverage must have been through a group health plan, governmental plan, or church plan.
3. You must have elected and exhausted all continuation health care coverage available under federal (COBRA) and state continuation coverage laws.
4. You must not currently have other health care coverage and not be eligible for coverage under any group health plan, governmental plan, church plan, state-administered Medicaid program, or Medicare.
5. Your most recent coverage was not terminated for fraud or failure to pay premiums.
For more information about the Conversion or HIPAA Plan, call Kaiser Member Services at 1-800-634-4579.

If you do lose your job, your employer may or may not be able to help redirect you to an alternative option. Knowing that options are available can make the transition a little bit smoother.

Pre-School or Elementary School Age
Young children tend to need low-ticket medical services more than major medical services. Often, this involves doctor visits, prescriptions, and immunizations. If you want a basic plan that covers at least these services right up front, consider one of the “HMO” Deductible plans. Most of the HMO Deductible plans allow for doctor visits, prescriptions, and immunizations without these services being subject to the deductible. If you want a more comprehensive plan for more peace of mind, then, check out the “Copayment” options. These plans don’t carry a deductible, so covered services are discounted right at the beginning.

Middle or High School Age
At this age, the most frequently needed medical services tend to be doctor visits and prescriptions. Consider an HMO Deductible plan. If the child is in sports, it may be good to go with a Copayment plan, or an HMO Deductible plan with a lower deductible.

College Age
For those looking for college-age student health insurance, doctor visits and prescription drugs may not be as crucial as when they were younger. Instead, having a good major medical plan may make more sense. An HSA or HMO Deductible plan may be the best fit. An HSA option gives you the bonus feature of being able to open an HSA bank account. The HSA bank account is optional. Your child can use it to pay for their out-of-pocket expenses. The advantage of an HMO Deductible plan is that under most HMO Deductible plans, doctor visits and prescriptions are covered without a deductible.

Premiums and your pocketbook
Copayment plans cost the highest premium, but if your child tends to need lab work, emergency visits, or other high-end services, this option will save you money in the long run. HSA Deductible plans tend to have the lowest premium, but high deductible amounts. If your child is rarely at the doctors, this may be a win-win situation. HMO Deductible plans are a good middle-of-the-road option. Premiums are lower than Copayment plans, but you still get the most frequently needed services of doctor visits and prescriptions without a deductible.

As your child begins a new school year, consider how Kaiser Permanente can support you and your family with their medical service needs.

Copayment Plans
This group of plans includes the $50 Copay Plan, the $30 Copay Plan, the $20 Copay Plan, the $15 Copay Plan and the $5 Copay Plan. For preventative exams, formerly members had to pay the doctors copay, but now there is a $0 charge for preventative exams. With Regard to maternity/prenatal care, the $50 Copay Plan formerly required a $15 copay, but now there is a $0 charge for this service. For all other Copay Plans, there was and continues to be a $0 charge for maternity/prenatal care. Be aware that this is not referring to the hospitalization charges that are required upon delivery of the baby. Those same charges for in-patient care still apply according to the terms of your plan. For well-child preventative care visits, the $50 Copay Plan formerly charged $15, but now it is a $0 charge like the other Copay Plans. For vision exams, Kaiser Permanente formerly charged the same copay as for doctor visits on these plans, but now there is a $0 charge on all the Copay Plans for vision exams.

HSA-Qualified Deductible HMO Plans
The $30/$3,000 Deductible Plan with HSA is the only plan in this category that will be undergoing changes. The other HSA-qualified HMO plans will remain the same. On the $30/$3,000 Plan, formerly preventative exams cost $30 while maternity/prenatal care and well-child preventative care visits cost $10. As of October 1, 2010 there will be a $0 charge for these services on the $30/$3,000 Plan with HSA.

Deductible HMO Plans
This category includes three plans: the $40/$2,000 Deductible Plan, the $30/$1,500 Deductible Plan, and the $30/$1,000 Deductible Plan. All three of these plans will have improved coverage for preventative exams and vision exams starting on October 1st. Formerly, these exams required the payment of a doctors copay; however, on October 1st these Deductible Plans will have a $0 charge for both vision exams and preventative exams.

A Pap smear, also called a Pap test, is a procedure to test for cervical cancer in women. Generally, it is recommended every 3 years starting at age 21, or earlier if the woman is sexually active. The test is done as part of a routine pelvic exam, so the cost for the actual exam is included in the fee for the doctor’s visit. The Pap smear is a lab test and will be separate from the doctor’s visit. It will either be ‘no charge’ or $10, depending on the plan you are on.

A mammogram is an x-ray which helps detect breast cancer. It is recommended every 1 to 2 years for women age 40 to 74. Women age 75 and older may want to ask their doctor about whether they need this test.

Your doctor may recommend either of the above tests at a younger age if you or your family has a history of cancer, or if other risk factors apply.

Having these preventive tests done routinely is a good way of taking care of yourself at minimal cost.

An “emergency” is a medical or psychiatric condition that puts a person’s health in serious jeopardy, or presents serious impairment to bodily functions, or a serious dysfunction of any bodily organ or part. Kaiser will cover emergency care anywhere in the world, even if the services are obtained at a non-Kaiser facility.

If a Kaiser member is experiencing a medical problem and needs professional advice, they can call their home Kaiser from anywhere in the world and speak with an advice nurse, 24 hours a day / 7 days a week. If the member is involved in an emergency, then, as soon as reasonably possible, they should contact the Kaiser Emergency Line at 1-800-225-8883 or the notification telephone number on the Kaiser ID card.

Once the doctor determines that the condition is clinically stable, then, any additional services (“post-stabilization care”) may need to be approved in advance by Kaiser in order to be covered. If the post-stabilization care is received at the member’s local Kaiser (“pass go”), pre-authorization and claim forms are not required. If the care is provided at Kaiser but in another state or region, pre-authorization is not needed, but a claim form would be. For post-stabilization care at a non-Kaiser facility, both pre-authorization and a claim form would be needed.

If the emergency and/or post-stabilization care is provided outside of the member’s local Kaiser, then, the treating facility will bill the member. To receive reimbursement, a claim would need to be submitted. The claim process can take from 30 days, up to 6 months. During this time, the member will be billed. If the member pays the bills, it will delay the reimbursement process by another 6-8 weeks approximately. If the member does not pay the bills, there is a possibility that a collections agency may get involved. However, adverse effects would be reversed once the claim is resolved. Note: The member is still responsible for their share of the cost, if any, depending on the insurance plan.

To file a claim form, call Kaiser Member Services at 1-800-464-4000 or the Claims Department at 1-800-390-3510 for assistance. For Kaiser members in California, claim forms and attachments can be mailed to:

For Northern CA Members:
Kaiser Foundation Health Plan, Inc.
Claims Department
P.O. Box 12923
Oakland, CA 94604-2923

For Southern CA Members:
Kaiser Foundation Health Plan, Inc.
Claims Department
P.O. Box 7004
Downey, CA 90242-7004

Emergencies are never pleasant, but at least, it’s good to know what to expect should an emergency arise.

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

PLEASE REVIEW IT CAREFULLY.

In this notice we use the terms “we,” “us,” and “our” to describe KQ Insurance Services.com, Incorporated.

We can be reached via email, or
you can reach us by telephone at: 1-877-752-4737

Privacy Statement

For each visitor to our Web page, our Web server automatically recognizes no information
regarding the domain or e-mail address. We collect the e-mail address of those who communicate
with us via e-mail, aggregate information on what pages consumers access or visit, user
specific information on what pages consumers access or visit and information volunteered
by the consumer, such as survey information and/or site registrations.

The information we collect is used for internal review and is then discarded, used to
improve the content of our Web page, used to customize the content and/or layout of our page
for individual consumer and used by us to contact consumers for marketing purposes.

If you do not want to receive e-mail from us in the future, please let us know by sending
an e-mail, calling or writing, and telling us that you do not want to receive e-mail from
our company.

Terms of Use Statement

You understand and agree that the owners of this site shall not be liable for any direct,
indirect, incidental, consequential or exemplary damages, including but not limited to,
damages for loss of profits, data or other intangible losses (even if the owners of this
site have been advised of the possibility of such damages), resulting from the use or the
inability to use the product(s) and or service(s) or any misuse of the product(s) and or
service(s) in a manner not in accordance with their intended use.

Use of Customer Personal and Health Information by Kaiser Permanente

In addition, medical information filed with KaiserQuotes.com is automatically submitted to Kaiser
Permanente. To review Kaiser Permanente’s privacy policies, please click Privacy
Practices.

I. WHAT IS “PROTECTED HEALTH INFORMATION?”

Your protected health information (PHI) is health information that contains identifiers, such as your name, Social Security number, or other information that reveals who you are. For example, your medical record is PHI because it includes your name and other identifiers.

II. ABOUT OUR RESPONSIBILITY TO PROTECT YOUR PHI

By law, we must

1. protect the privacy of your PHI,
2. tell you about your rights and our legal duties with respect to your PHI, and
3. tell you about our privacy practices and follow our notice currently in effect.

We take these responsibilities seriously and, as in the past, we will continue to take appropriate steps to safeguard the privacy of your PHI.

In the course of providing health care, we collect various types of PHI from members and patients and other sources, including other health care providers. The medical information may be used, for example, to provide health care services and customer services, evaluate benefits and claims, administer health care coverage, measure performance (utilization review), detect fraud and abuse, and fulfill legal and regulatory requirements. The types of PHI that we collect and maintain about applicants include, for example:

• Information from members/patients, for example, through surveys, applications and other forms, and online communications; and
• Information about your relationship with Kaiser Permanente such as medical services received, claims history, and information from your benefits plan sponsor or employer about group health coverage you may have.

III. YOUR RIGHTS REGARDING YOUR PHI

This section tells you about your rights regarding your PHI. It also describes how you can exercise these rights.

Your right to see and receive copies of your PHI

In general, you have a right to see and receive copies of your PHI in designated record sets such as your application. If you would like to see or receive a copy of such a record, please write us.

In limited situations, we may deny some or all of your request to see or receive copies of your records, but if we do, we will tell you why in writing and explain your right, if any, to have our denial reviewed.

Your right to choose how we send PHI to you

You may ask us to send your PHI to you at a different address (for example, your work address) or by different means (for example, fax instead of regular mail). When we can reasonably and lawfully agree to your request, we will. However, we are permitted to charge you for any additional cost of sending your PHI to different addresses or by different means.

Your right to correct or update your PHI

If you believe there is a mistake in your PHI or that important information is missing, you may request that we correct or add to the record. Please write us and tell us what you are asking for and why we should make the correction or addition.

Your right to an accounting of disclosures of PHI

You may ask us for a list of our disclosures of your PHI. Write to us to make this request. The list we give you will include disclosures made in the last six years, unless you request a shorter time.

You are entitled to one disclosure accounting in any 12-month period at no charge. If you request any additional accountings less than 12 months later, we may charge a fee.

Your right to request limits on uses and disclosures of your PHI

You may request that we limit our uses and disclosures of your PHI for treatment, payment, and health care operations purposes. However, by law, we do not have to agree to your request. Because we strongly believe that this information is needed to appropriately manage the care of our members/patients, it is our policy to not agree to requests for restrictions.

Your right to receive a paper copy of this notice

You also have a right to receive a paper copy of this notice upon request.

IV. COMPANIES SUBJECT TO THIS NOTICE

This notice applies to KQ Insurance Services, Incorporated.

Our personnel may have access to your PHI as benefits specialists and for the transfer of applications to Kaiser Permanente Insurance Company.

V. HOW WE MAY USE AND DISCLOSE YOUR PHI

Your confidentiality is important to us. Our employees are required to maintain the confidentiality of the PHI of our applicants and we have policies and procedures and other safeguards to help protect your PHI from improper use and disclosure. Sometimes we are allowed by law to use and disclose certain PHI without your written permission. We briefly describe these uses and disclosures below and give you some examples.

How much PHI is used or disclosed without your written permission will vary depending, for example, on the intended purpose of the use or disclosure. Sometimes we may only need to use or disclose a limited amount of PHI.

• Communications with family and others when you are present: Sometimes a family member or other person involved in your care will be present when we are discussing your PHI with you. If you object, please tell us and we won’t discuss your PHI or we will ask the person to leave.
• Communications with family and others when you are not present: There may be times when it is necessary to disclose your PHI to a family member or other person involved in your care because there is an emergency, you are not present, or you lack the decision making capacity to agree or object. In those instances, we will use our professional judgment to determine if it’s in your best interest to disclose your PHI. If so, we will limit the disclosure to the PHI that is directly relevant to the person’s involvement with your health care. For example, we may allow someone to pick up a prescription for you.
• Required by law: In some circumstances federal or state law requires that we disclose your PHI to others. For example, the secretary of the Department of Health and Human Services may review our compliance efforts, which may include seeing your PHI.
• Lawsuits and other legal disputes: We may use and disclose PHI in responding to a court or administrative order, a subpoena, or a discovery request. We may also use and disclose PHI to the extent permitted by law without your authorization, for example, to defend a lawsuit or arbitration.
• Law enforcement: We may disclose PHI to authorized officials for law enforcement purposes, for example, to respond to a search warrant, report a crime on our premises, or help identify or locate someone.
• Serious threat to health or safety: We may use and disclose your PHI if we believe it is necessary to avoid a serious threat to your health or safety or to someone else’s.
• Abuse or neglect: By law, we may disclose PHI to the appropriate authority to report suspected child abuse or neglect or to identify suspected victims of abuse, neglect, or domestic violence.
• Coroners and funeral directors: We may disclose PHI to a coroner or medical examiner to permit identification of a body, determine cause of death, or for other official duties. We may also disclose PHI to funeral directors.
• Inmates: Under the federal law that requires us to give you this notice, inmates do not have the same rights to control their PHI as other individuals. If you are an inmate of a correctional institution or in the custody of a law enforcement official, we may disclose your PHI to the correctional institution or the law enforcement official for certain purposes, for example, to protect your health or safety or someone else’s.

VI. ALL OTHER USES AND DISCLOSURES OF YOUR PHI REQUIRE YOUR PRIOR WRITTEN AUTHORIZATION

Except for those uses and disclosures described above, we will not use or disclose your PHI without your written authorization. When your authorization is required and you authorize us to use or disclose your PHI for some purpose, you may revoke that authorization by notifying us in writing at any time. Please note that the revocation will not apply to any authorized use or disclosure of your PHI that took place before we received your revocation. Also, if you gave your authorization to secure a policy of insurance, including health care coverage from us, you may not be permitted to revoke it until the insurer can no longer contest the policy issued to you or a claim under the policy.

VII. HOW TO CONTACT US ABOUT THIS NOTICE OR TO COMPLAIN ABOUT OUR PRIVACY PRACTICES

If you have any questions about this notice, or want to lodge a complaint about our privacy practices, please let us know by calling 1-877-752-4737 extension 405. You also may notify the secretary of the Department of Health and Human Services.

We will not take retaliatory action against you if you file a complaint about our privacy practices.

VIII. CHANGES TO THIS NOTICE

We may change this notice and our privacy practices at any time, as long as the change is consistent with state and federal law. Any revised notice will apply both to the PHI we already have about you at the time of the change, and any PHI created or received after the change takes effect. Except for changes required by law, we will not implement an important change to our privacy practices before we revise this notice.

IX. EFFECTIVE DATE OF THIS NOTICE

This notice is effective on February 4, 2008.

Kaiser Permanente offers some of the most advanced health care available while maintaining affordable rates. With Kaiser insurance coverage, you will receive high quality medical care from one of the most sophisticated health care providers in the world. Use the links above to get Kaiser health insurance quotes on individual and group plans.

Kaiser Permanente Medical Coverage Benefits

Kaiser medical coverage includes doctor visits, prescription drugs, specialist care, emergency room visits, ambulance rides, hospitalization/in-patient care, laboratory and radiology and much more. You’ll have access to your online medical records and be able to connect with your doctor by email. Kaiser Permanente health plans continue to rank #1 for quality of care in the regions they serve. Kaiser Permanente providers can be found in Hawaii, Northern California, Southern California, Oregon, Washington, Colorado, Georgia, Ohio, Maryland, Virginia, and Washington D.C. The Kaiser plan is designed to get you well, keep you well, and help you gain a higher quality of life. As the motto says, Kaiser Permanente insurance coverage is designed to help you and your family to thrive.

Deductibles & the Kaiser Health Plan

Traditionally, in the past Kaiser plans have been what is referred to as Copayment Plans, meaning that they do not have deductibles. These Kaiser health plans offer set copayments on all health care services. That means no unexpected costs, but it also means higher premiums on health insurance coverage. In order to decrease the cost of Kaiser Permanente health insurance, the carrier has increased its offerings of deductible plan coverage. Deductibles mean increased savings on monthly premiums. The higher the deductible is, the more the savings.

Kaiser HMO Plans

Almost all Kaiser coverage is HMO coverage. HMO stands for health maintenance organization. In an HMO, the health insurance provider, the hospital / medical facilities, and the medical staff are all a part of the same organization. As an HMO, Kaiser benefits its members by uniting these three to keep costs low and keep the quality of care high. KP health insurance plans always include high quality HMO Kaiser Permanente coverage. Most services are rendered at the HMO medical facilities. However, home health care is available on many of the plans. See your plan benefits for specific details regarding Kaiser home health care. Kaiser PPO plans are not available on the individual side, but there are some group health Kaiser plans that include PPO coverage.

Kaiser Individual Health Insurance

Kaiser individual insurance can be even more affordable than Kaiser small business plans, especially if the business group has only a few number of employees. Kaiser medical insurance for individuals can be denied for pre-existing health conditions. If you are currently pregnant when you apply, you will be automatically denied. Other serious health conditions such as cancer, heart problems, HIV/Aids, and diabetes will almost certainly result in a denial of coverage from the Kaiser Permanente Health Plan. Though this can be quite disheartening for individuals and families who are denied, it can allow Kaiser Providers to offer Kaiser insurance plans at more affordable rates for those who do pass medical underwriting. Also, keep in mind that those on Kaiser Permanente health plans for individuals and families have portable coverage. If you’re on a group plan, your coverage is dependent on the company you work for. If you change jobs, you may lose your medical insurance. However, if you are on and individual health insurance plan, you can take that coverage with you whether or not you change careers.

Kaiser Insurance Rates

You can get a Kaiser insurance quote easily online for either individual or group coverage. Kaiser rates are determined by age, gender and location. Kaiser medical plans for small business also vary their rates based on the size of the group. Older applicants tend to pay more than younger enrollees. Also, for certain age bands, women will have higher rates than men. If you qualify for Kaiser group health coverage as well as individual, you may want to get quotes for both to compare benefits and cost. Keep in mind that the most effective way to save on your monthly premiums is to get a deductible plan or if you already have a deductible plan to get a Kaiser health insurance plan with a higher deductible. The trick is finding the right balance of coverage and affordability. Currently, KP’s most popular plan is the $1500 Deductible Plan because many find that this plan has the right balance of rich enough coverage and low enough cost. Get Kaiser health insurance quotes online by using the links above.

Kaiser Health News

The Kaiser Permanente Insurance Company (KPIC), the Kaiser Permanente Health Plan (KPHP) and the Kaiser Family Foundation (KFF) are regularly in the news for issues related to advances in health care and for health care reform. The Health Care Reform Act, often referred to as “Obama Care”, has been influenced by the Kaiser Health Coverage Plan. President Barack Obama has occasionally met with KP President George Halverson to discuss issues related to health care reform. Kaiser Permanente Health News will continue to be in the limelight as the carrier services its 8.5 million members and as Washington D.C. looks to Kaiser Permanente for its contribution in solving the health care crisis in America.

Kaiser Permanente Dental

Kaiser dental insurance can be added to most of their health plans. Kaiser Permanente California, for instance, allows you to add a dental rider to any of their individual or group medical plans. When applying for a plan, ask your agent or broker what dental riders are available to be added to your Kaiser Permanente medical insurance.

Kaiser Permanente HSA Plans

Kaiser HSA coverage has increased in popularity due to the tax advantages of these plans. HSA stands for health savings account. If you enroll in a Kaiser medical plan with HSA, you have the option of opening a health savings account at Wells Fargo, Patelco or the financial institution of your choice. Money put into these accounts is ear-marked for medical expenses and is tax-deductible on your federal taxes. The money can gain interest while in your account. Also, unused funds in these accounts remains yours from year to year and is an inheritable asset upon your passing. Many who enroll in an HSA Plan never actually open a health savings account. If you have HSA coverage, you have the option of opening a health savings account, but if you don’t have an HSA health plan, you may not legally open a health savings account. The HSA Kaiser health insurance plans are appealing because they often have lower out-of-pocket maximums than some of the other deductible plans.

Around 2007 and 2008, many carriers came out with low out-of-pocket maximum HSA plans at very affordable rates. Brokers and agents began selling many plans like Kaiser’s $0/$1500 Deductible Plan with HSA. This plan offered 100% coverage after a $1500 spend and tended to attract enrollees with expensive healthcare needs. Due to adverse selection, health care providers lost a lot of money on these plans and were forced to implement large rate increases upwards of 20% in 2009. The rate increases were not enough to offset the cost to the Health Plan, so in 2010 Kaiser Permanente doubled the out-of-pocket maximum on many of their HSA plans while at the same time adding another large rate hike. In 2007 and 2008, the Kaiser Permanente HSA Plans were an exceptional deal; however, due to decreased benefits and increased rates that is no longer the case. Most agents today would recommend the regular $1500 Deductible Plan over the $0/$1500 Deductible Plan with HSA that was once so popular.

Kaiser Maternity

Kaiser Permanente coverage includes maternity on most medical plans. However, if you are applying for an individual plan, it is essential to enroll before getting pregnant in order to avoid being denied coverage. Pregnancy is considered a pre-existing condition and will result in an automatic denial. Those looking for maternity coverage, often choose Kaiser Permanente healthcare because of the exceptional success rate Kaiser doctors have with delivering babies. According to a recent documentary, The Business of Being Born, infant morbidity rates (occurrences of problems and disease in delivery) are higher in the United States than in Europe. However, Kaiser Permanente rates of morbidity are even lower than those in Europe. The healthiest and safest way to have a baby in the USA, is deliver your child with a Kaiser Permanente provider.

Kaiser Medicare and Kaiser Senior Advantage

Kaiser Permanente Medicare coverage is offered through Senior Advantage. Upon turning 65, seniors qualify for Medicare coverage and may apply with Kaiser Permanente Senior Advantage months before turning 65. The Kaiser Permanente contact number for Senior Advantage customer service is 1-877-882-2703. Make your choice for a Medicare plan the Kaiser choice!

Note: The Kaiser Permanente Claims Department can be reached by calling 1-800-390-3510 .