Deductibles & coinsurance

Some health plans require deductibles, coinsurance, or both. In both cases:

  • The member is responsible for paying any applicable deductible or coinsurance.
  • You may bill for deductibles and coinsurance after you receive a remittance statement explaining how much to collect from the member.

While a Medicare hospice election is in effect, we will pick up the covered balances (deductible or coinsurance) after Medicare makes payment for non-hospice related services.

Any billings to the member for deductibles, copayments, or coinsurance must be at the lesser of the negotiated rate for covered services, as defined in your contract with Kaiser Permanente, or the billed amount. Payment from Kaiser Permanente will be made at the negotiated rate minus any applicable copayments, coinsurance, or deductibles.

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