You have
Benefits Unit
Kaiser Permanente Hawaii for Retirees
At Kaiser Permanente Hawaii, the spirit of aloha has shaped our daily actions and interactions since 1958. This mission continues today as we care for our 229,000 members at our 235-bed medical center in Honolulu, 18 outpatient clinics on the islands of Oahu, Hawaii, and Maui, and through independent primary care providers on Kauai, Lanai, and Molokai. Kaiser Permanente Hawaii is a $15 copay HMO.
Members in Hawaii receive services from more than 4,400 employees and more than 440 Hawaii Permanente Medical Group, Inc., physicians. All facilities are supported by our regional offices, located in Honolulu.
Hawaii families have trusted their care to Kaiser Permanente for over 50 years. See for yourself how Kaiser Permanente Hawaii can help your family live longer, and healthier lives in the islands.
Customer Service and Group Number
For specific questions about benefits, you may call our Member Services at 800-966-5955.
Hawaii Permanente Group #: 03003 / 058
Premium Rates
For Retirees
Medicare Monthly Medical Plan Premiums
Non-Medicare Monthly Medical Plan Premiums
Benefit Charts
Employees and Retirees
Medical Plan Summary
Office Visits and Professional Services
Surgical and Hospital Services
Prescription Drugs
Medical Plan Summary
| Plan Information | Kaiser Permanente Hawaii HMO |
|---|---|
| Calendar Year Deductible | None |
| Coinsurance | None |
| Calendar Year Out of Pocket Maximum
(Including Deductibles, Co-pays, and Coinsurance) | Maximum per Member: $2,500 |
| Lifetime Maximum | None |
| Dependent Children Eligibility | Any Dependent Child under age 26. No age limit if disabled. |
Office Visit and Professional Services
| Service | Kaiser Permanente Hawaii HMO |
|---|---|
| Physician & Specialist Office Visit | $15 copay |
| Preventive Care Birth to Age 18 | No Charge |
| Preventive Care Adult routine Care | No Charge |
| Preventive Care Adult Routine OB/GYN | No Charge |
| Diagnostic Lab and X-ray | 10% Coinsurance |
| Physical Therapy (Medically necessary treatment only) | $15 copay medically necessary treatment only |
| Mental Health & Substance Abuse (Outpatient) | $15 copay |
| Hearing Aids | 60% Coinsurance every 36 months |
Surgical and Hospital Services
| Service | Kaiser Permanente Hawaii HMO |
|---|---|
| Inpatient Hospital and Physician Services | $75 copay |
| Outpatient Surgery | $15 copay |
| Maternity | No Charge |
| Emergency Room | $75 copay within Hawaii Service Area; 20% Coinsurance outside Hawaii Service Area |
| Mental Health & Substance Abuse (Inpatient) | $75 copay |
| Skilled Nursing Facility | No Charge.
Up to 120 days per benefit period |
Prescription Drugs
| Service | Kaiser Permanente Hawaii HMO |
|---|---|
| Generic or Formulary Brand | $15 copay; 30 day supply |
| Mail Order Benefit | $30 copay: 90 day supply |
| Mandatory Mail Order | No |
| Mandatory Generic Program | Not available |
Service Area
Medical facilities
Medical offices
We own and operate 18 clinics in the Hawaii Region. Four are located on Hawaii, four are located on Maui, and the remaining 10 are located on Oahu.
Medical centers and hospitals
Moanalua Medical Center on Oahu is the only Kaiser Permanente–owned and operated medical center in Hawaii. We are affiliated with nine community hospitals:
• Hilo Medical Center — Hawaii
• Kona Community Hospital — Hawaii
• Lanai Community Hospital — Lanai
• Maui Memorial Medical Center — Maui
• Molokai General Hospital — Molokai
• North Hawaii Community Hospital — Hawaii
• Samuel Mahelona Memorial Hospital — Kauai
• West Kauai Medical Center — Kauai
• Wilcox Memorial Hospital — Kauai