8/6/2019 Kaiser Permanente July Rates 2011 RA1 CA KPIF
2/4
Have a qestio? Were here to help. Call 1-800-569-1156 .
Or visit
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How to fnd your rate
Simply fd yor ZIP code i the list elow to cofrmyor rate area.
The locate yor desired pla o page 3.
Yor rate will appear i the ox where yor age ad rate
area itersect with yor pla.
Rememer that or services sject to a dedctile, yo
will have to pay health care expeses ot o pocket til
yo meet yor dedctile. For iormatio descriig
the eefts ad limitatios, cost-sharig amots,
premims, ad detal plas, please review the details
i yor erollmet material. To reqest a copy o the
Membership Agreementor Certifcate o Insurance or
a particlar pla, please call s at 1-800-494-5314 orcotact yor
aget or roker.
What determines your rateYor rate is ased o the ollowig:
n the pla yo selectn where yo live, ased o yor ZIP code
n yor age as o Jly 1, 2011
I yo move ad chage yor home ZIP code, yor
mothly rate will chage.
Try dierent combinations
Family memers do ot have to apply or the same pla.Each amily
memer who qalifes will e erolled der
his or her ow pla at a separate rate. This allows yo
to select dieret plas or dieret amily memers,
depedig o their eeds. For example, yo might wat
the predictale cost share o a copaymet pla, while yor
spose might e iterested i the lower premim o a
dedctile pla. The choice is yors.
Medicare-eligible subscribersI yo are 65+ years o age ad
Medicare eligile or are
der age 65 ad etitled to Medicare o the asis o
Social Secrity disaility, yo may e eligile or lowerrates der
Kaiser Permaete Seior Advatage.
Please call 1-800-290-3829 or iormatio.
IMPORTAnT InFORMATIOnAbOuT OuR RATES
ZIP codes or Rate Area 1Please veriy that yor ZIP code is listed
elow. I yor ZIP code is ot listed, cotact s at 1-800-494-5314
oriormatio o other rate areas.
940029400594010119401428940309403594037449406066940709407494080
94083940858994101059410712941143494137941394794151941569415864
941729417794188941999420309942119422930942329423437942394094244
94246509425294254942565994261639426769942719427374942779427980
9428291942939894301069430994401049449794501039450531945335394555839458592
94595999460115946172494649946596294666947011094712947209480108
94820948509490194903049491215949209492231949339493742949455794960
94963669497079949999500295008099501195013159502021950269503033
950353895042950449504695050569507071950769510195103951069510813
95115369513841951489515061951649517095172739519094951969540107
95409954169541995421954259543031954339543695439954414295444
954469544895450954529546295465954717395476954868795492
9560205956072195623269562895630956323595638409564595648956505295655
9565864956677495676789568083956878895690989570395722957369574142
95746479575759957626395765957769579899958113895840439585153958609586467
95894958999590395961
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