Under this Kaiser-administered plan, you can choose any healthcare provider within one single statewide network. It is recommended that you select a Primary Care Physician to direct your care. In most cases, referrals are required. However, you may self-refer to certain specialists. In place of a deductible, enrollees will be responsible for a copay for medical visits, diagnostic testing and hospital/facilities services.
Out-of-network care is not covered except for emergency and/or urgent care.
- CU Health Plan - Kaiser Benefits Coverage Summary (9 pages)
- CU Health Plan - Kaiser Benefits Booklet (138 pages)
- Kaiser Preventative Care Guidelines
Covered providers and medications
Out-of-area benefit for dependents only
This benefit applies to services listed in the Summary Chart (page 128 of Benefits Booklet).
Primary care, Specialty, Mental Health/Chemical Dependency, Well Child prevention, Gynocological and Allergy injection visits are covered. All other visits are not covered.
|Office visit limits (procedures and labs are excluded)||5 visits per plan year|
|Diagnostic X-ray service limits (X-ray and Ultrasound only)||20% coinsurance
5 per plan year
|Physical, Occupational & Speech Therapies||5 combined visits per plan year|
|Features and Considerations|
|Plan Type||EPO - Kaiser network|
|Out-of-Pocket Limit||$7,900/Individual; $15,800/Family|
|Office Visit||PCP - $30/visit
Specialist - $40/visit
Urgent Care - $30/visit
|Emergency Care||$250 (waived if admitted)|
|Prescription Drug (Rx)
Non-Preferred Brand: Not Covered
Preferred Brand: $35
Specialty: 20% of cost up to $75
|Mail Order (Rx)
|Cost Savings: 90-day supply for the prices of a 60-day supply|