What you need to know
The Kaiser Colorado plan is designed to provide you with comprehensive health care coverage while promoting cost-effective, coordinated care. The plan is only available to SMS Sector employees in Colorado* and does not provide coverage for out-of-network services (except in cases of emergency or urgent care when you are away from your designated service area).
Your Kaiser Colorado medical plan option
The Kaiser Colorado medical plan option features:
- A requirement to receive all care (except for emergencies) through Kaiser doctors, pharmacies, and facilities, and to get referrals to see specialists (except in-network ob-gyns).
- No deductible.
- 100% coverage for preventive care (no out-of-pocket cost to you for annual physical exams, lab tests, and age-appropriate screenings).
- Office visits and prescription drugs covered in full after your copay.
- An out-of-pocket maximum (the MOST that you’ll pay in a year for medical services) of $2,000 for individual coverage or $4,500 per family.
- Prescription drug benefits administered through Kaiser.
Note: Kaiser strongly encourages members to select a primary care physician.
Learn more about Kaiser.
What you pay for in-network care
| Plan Feature | Kaiser Colorado |
|---|---|
| Preventive Care | Covered 100% in-network |
| Deductible | None |
| Out-of-pocket maximum | $2,000 individual $4,500 family |
| Primary care | You pay $25 |
| Specialist | You pay $35 |
| Inpatient hospital | You pay $500 |
| Outpatient/Ambulatory surgery | You pay $50 |
| Emergency room | You pay $125 |
| Ambulance | You pay $50 per trip |
| Urgent care | You pay $50 |
| Prescription – retail 30-day supply | $15 generic/$30 brand |
| Prescription – mail order 100-day supply | $30 generic/$60 brand |
* Eligible employees in Hawaii have the option of regional coverage with Kaiser Hawaii or HMSA.
TRICARE Supplement Insurance
TRICARE is the Department of Defense’s health benefit program for the military community. TRICARE Supplement Insurance is a voluntary insurance plan designed to supplement your TRICARE benefits and help minimize health care expenses. Learn more about the program and determine your eligibility.
Kaiser Colorado medical plan
Health and insurance information
8 a.m.–8 p.m. Eastern Time, Monday through Friday
+1 718 354 1341 (outside the U.S.)