Health care reform

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Find out how the health care reform law affects you. Understanding the Affordable Care Act (ACA)

On March 23, 2010, the ACA became federal law. It made the most significant changes in the U.S. health care system since Medicare was established in 1965.
As an integrated health care delivery system serving more than 10 million members nationwide, our organization and its members were affected by the law in many different ways. Read on to find out what this means for your coverage options.

For Kaiser Permanente members

We encourage you to keep getting the most out of the convenient care and health resources you rely on. We’ll continue to keep you informed about your options or anything that affects your coverage.

I’m covered by my employer

Greater peace of mind for you and your family

If you currently have health care coverage through your employer, you may be enjoying some of the added benefits from health care reform. For example, the following benefits are in effect for plans that must comply with the requirements of the Affordable Care Act (ACA).*

*Some of these benefit changes don’t apply to “grandfathered” health plans. Your employer and your issuer should let you know if your plan is grandfathered.

If you work for a large company

You can get coverage through your employer or through the Health Benefit Exchanges (also known as the marketplaces). Check with your employer for more information during your next annual open enrollment period.

If you work for a small business

Check with your employer for information on how to get coverage. You may be able to select coverage through your employer, the Small Business Health Options Program (SHOP), through your local health benefit exchange, or through us. In the District of Columbia, you can only apply through DC Health Link.

Visit healthcare.gov to review SHOP options for each state (federal vs. state-based health benefit exchange). If your employer doesn't offer health coverage, you may be able to get federal financial assistance. Visit your local health benefit exchange to find out if you qualify.

I’m covered on my own

It feels good to know you’re covered

Our health plans include all the protections of the health care law.

If you decide to change plans, you can visit the health benefit exchange to compare health plans. If you find a plan that better meets your needs, you can buy it through the health benefit exchange or purchase a plan directly from us during the annual open enrollment period or when you have a qualifying life event. Qualifying life events open up a special enrollment period.

You may be able to get federal financial help if you qualify. To do so, you need to apply and get your coverage through the health benefit exchange. You may also qualify for additional state financial assistance, even if you haven't qualified for federal financial assistance in prior years.

If you're a Kaiser Permanente member, we’ll continue to have information to help keep you informed about your options or anything that affects your coverage.

Keep in mind the value of staying with Kaiser Permanente — including the care and issuers you know and trust, and the convenient services you’ve come to rely on.

Greater peace of mind for you and your family

If you currently have individual or family health care coverage, you may be enjoying some of the added benefits from health care reform. For example, the following benefits are in effect for plans that must comply with the requirements of the Affordable Care Act (ACA).*

*Some of these benefit changes don't apply to “grandfathered” health plans. Your employer and your issuer should let you know if your plan is grandfathered.

More options for how you get and pay for coverage

Financial help from the federal or state government

There are 2 kinds of federal financial help that may be available to you. One kind helps pay your monthly health plan premium. The other helps with your out-of-pocket expenses for care. You may qualify for one or both, and the federal government can pay your health plan directly.

For some general income guidelines and to see if you qualify for federal financial help, visit buykp.org. You can also compare plans, calculate your rate, or apply online.

Health Benefit Exchanges

Health benefit exchanges are federally or state-run exchanges where you can shop, compare, and buy individual, family, or group health care coverage. They are sometimes called “marketplaces.”

(Exception: Residents of the District of Columbia, purchasing health care coverage on their own must buy coverage from their marketplace.)

Levels of coverage

Health benefit exchanges offer health plans from different companies and several levels of coverage. You can choose a plan that meets your personal situation and needs.

All plans are grouped into several levels of coverage. These levels (referred to as metal plans) make it easier for people to compare plans offered by different insurance companies.

For more information on special enrollment periods and qualifying life events, visit kp.org/specialenrollment.

Kaiser Permanente members

Link directly to the health benefit exchange for your region here.

State or jurisdiction URL
California CoveredCA.com
Colorado connectforhealthco.com
District of Columbia dchealthlink.com
Georgia healthcare.gov
Maryland marylandhealthconnection.gov
Oregon healthcare.gov
Virginia healthcare.gov
Washington state wahealthplanfinder.org
Hawaii hawaiihealthconnector.com

I’m a Medicare beneficiary

Kaiser Permanente is committed to the Medicare program and to providing high quality care and service to our members at the best possible value.

If you’re a Kaiser Permanente Medicare health plan member, you don’t need to take any action to maintain your Medicare health plan coverage.

If you’re covered on your own, you can get information about Medicare health plans available to you by visiting medicare.gov. Information about our Medicare health plans is available on kp.org/medicare.

If you receive your coverage through an employer or trust fund, contact your group for information about your health care options.

I’m not covered

Take control of your health and your care

The Affordable Care Act (ACA) provides options for how you get and pay for coverage.

Why Kaiser Permanente?

There are many advantages to having health care coverage. And many more to having Kaiser Permanente. As a Kaiser Permanente member, you’ll get doctors, facilities, and health plans that work together as one. This makes your care more coordinated, convenient, and connected.

What all metal health plans have in common

Here are the added protections from health care reform that every metal plan includes.

More options for how you get and pay for coverage

Financial help from the federal government

There are 2 kinds of federal financial help that may be available to you. One kind helps pay your monthly health coverage premium. The other helps with your out-of-pocket expenses for care. You may qualify for 1 or both, and the federal government can pay your health plan directly.

For some general income guidelines and to see if you qualify for federal financial help, visit buykp.org. Here you can also compare plans, calculate your rate, or apply online.

Health Benefit Exchanges

Health benefit exchanges are federally or state-run exchanges where you can shop, compare, and buy individual, family, or group health care coverage. They are sometimes called “marketplaces.”

Or, you can get your coverage directly from us (unless you live in the District of Columbia). We’ll help you explore all your options and choose a plan that works best for you and your family. Federal financial help is only available when you buy coverage through your federal or state health benefit exchange.

Levels of coverage

Health benefit exchanges offer plans from different companies with several levels of coverage. You can choose the plan that's the best fit for your personal situation and needs.

For more information on qualifying life events and special enrollment periods, visit kp.org/specialenrollment.

Kaiser Permanente members

Link directly to the health benefit exchange for your region here.

State or jurisdiction URL
California coveredca.com
Colorado connectforhealthco.com
District of Columbia dchealthlink.com
Georgia healthcare.gov
Maryland marylandhealthconnection.gov
Oregon healthcare.gov
Virginia healthcare.gov
Washington state wahealthplanfinder.org
Hawaii hawaiihealthconnector.com

Medicaid & Charitable Health Coverage Programs

Kaiser Permanente is committed to providing high-quality, affordable health care services to all the communities we serve.

Medicaid is a federal and state health coverage program available to people who have low incomes and limited resources. If you qualify for Medicaid under your state’s program, you may be eligible to receive your Medicaid health care with Kaiser Permanente.

For more information and to see if Kaiser Permanente participates in Medicaid in your area, please visit kp.org/medicaid.

Kaiser Permanente's Charitable Health Coverage (CHC) programs provide health care coverage to low-income individuals and families who are not eligible for other public or private health coverage.

Qualifying individuals receive enrollment in a Kaiser Permanente for Individuals and Families health plan and a Kaiser Permanente subsidy to help pay monthly premiums and most out-of-pocket medical costs for most care at Kaiser Permanente facilities.

To learn more about qualifying for and enrolling in a Kaiser Permanente CHC program, please visit kp.org/chc.

Need coverage now?

We’ll help you find a plan that fits your needs.