This tool is intended to assist you in selecting which of the health plan options offered through your employer may be right for you. To use the tool, you will need to input the health plan cost information (premium, copay, etc) you receive during Open Enrollment and estimated usage of health care specific to your and your family’s personal situation.
This tool uses estimated average member charges for some commonly used medical services—such as primary care and specialist office visits, and prescription medicines when provided at Kaiser Permanente medical centers, medical offices, pharmacies, and other facilities — to generate your annual plan cost estimates based on your family composition. The Kaiser Permanente estimated average charges are updated on an annual basis and based on the
average severity level for a visit. Average brand and generic prescription drug charges are updated on a quarterly basis. All fees are subject to change without notice.
For illustrative purposes, the estimated average fees for office visits, brand and generic prescription drugs are used to calculate plan costs for Kaiser Permanente plans and plans of other carriers. The average fees are used in this tool to help calculate potential health plan costs. The actual office visit can only be determined at the time of visit or upon receipt of a bill, based on the severity level of the visit, as determined by your physician. The actual brand or generic prescription drug fees can only be determined at the time you receive your prescription from a pharmacy. When you receive care or services from a provider at a non–Kaiser Permanente facility, even if the provider is under contract to provide services for Kaiser Permanente members, the charges may be different and may not be reflected in this tool.
This tool should be used only a s a guide to determine the plan(s) that might be best for you and your family. For more detail about your plan offerings, talk to your health plan benefits administrator/coordinator before making any decisions.
The information that you enter into this tool cannot be linked directly to you. Any data that you input into the tool or the calculated results are not stored on our system.
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