Human Resources Benefits Unit

Kaiser Permanente Traditional HMO

Kaiser Permanente logo

Kaiser Permanente's microsite for County of Sonoma employees

The Traditional $10 Copay Plan provides access to comprehensive full-service medical care.

  • Doctor and specialist visits are available for a $10 copay. 
  • Most preventative services, such as well baby/child visits (up to 23 months), immunizations, routine physicals, mammograms, and routine preventative screenings are covered at no cost.
  • Hospitalization, radiology, and lab tests are also covered at no cost.
  • Prescription medication is covered at a copay range of $5 - $10. 

However, you must use Kaiser Permanente’s physicians, hospitals and other approved health care providers. Otherwise, you will not be eligible to receive benefits, except in a life-threatening situation such as an out-of-area urgent or emergency situation.

Plan Information Kaiser Permanente HMO
Calendar Year DeductibleNone
Calendar Year Out of Pocket Maximum
(Including Deductibles, Co-pays, and Coinsurance)

Maximum per Member: $1,500
Maximum per Family of 2 or more:

Lifetime Maximum None
Dependent Children Eligibility Any Dependent Child under age 26. No age limit if disabled.

Back to top

ServiceKaiser Permanente HMO
Physician & Specialist$10 co-pay
Preventive Care Birth to Age 18No Charge
Preventive Care Adult routine CareNo Charge
Preventive Care Adult Routine OB/GYNNo Charge
Diagnostic Lab and X-rayNo Charge
Physical Therapy (Medically necessary treatment only) $10 co-pay medically necessary treatment only
ChiropracticDiscounted rates through Kaiser Choose Healthy
Mental Health & Substance Abuse (Out-patient)

Individual Therapy: $10 co-pay
Group Therapy: $5 co-pay

Back to top

ServiceKaiser Permanente HMO
Inpatient Hospital and Physician ServicesNo Charge
Outpatient Surgery $10 co-pay
Maternity No Charge
Emergency Room $50 co-pay
Ambulance $50 per trip
Mental Health & Substance Abuse (Inpatient) No Charge
Skilled Nursing Facility No Charge.
Up to 100 days per benefit period
Home Health No Charge.
100 days per year

Back to top

ServiceKaiser Permanente HMO
Generic or Tier 1$5 co-pay 100 days supply
Formulary Brand or Tier 2$10 co-pay 100 days supply
Mail Order Benefit Generic or Tier 1Same as retail
Mail Order Benefit Formulary Brand or Tier 2Same as retail
Mandatory Mail OrderNo
Mandatory Generic ProgramNot available

Back to top

Contact Information

Benefits Unit

Human Resources Department

Business Hours
Monday – Friday
8:00 AM – 5:00 PM
Contact us by Phone
575 Administration Drive
Room 116 B
Santa Rosa, CA 95403
38.465237, -122.725363

Helpful Documents Kaiser Traditional HMO

Kaiser Permanente Plan Options