A Brief Overview of Kaiser Permanente in 2022

Kaiser Permanente, often referred to as simply Kaiser, is based in Oakland, California, and was founded in 1945 by industrialist Henry J. Kaiser and physician Sidney Garfield.

Kaiser Permanente is made up of three interdependent entities to form an integrated managed care consortium. These groups, or organizations, are the Kaiser Foundation Health Plan, Inc. (KFHP) and its regional operating subsidiaries – the Kaiser Foundation Hospitals, and the regional Permanente Medical Groups.

Unlike many of the major health insurance coverage providers, Kaiser Permanente is not found in every state nor even in most states. In fact, outside of California, Kaiser Permanente only serves members in Colorado, the District of Columbia, Georgia, Hawaii, Maryland, Oregon, Virginia, and Washington.

However, their customer base of members is close to 13 million people, and they are the largest managed care organization in the U.S.

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Kaiser Permanente: Spotlight on California

Currently in California, Kaiser Permanente has 9 million enrollees or members, which is close to a quarter of all Californians. In fact, Kaiser is the state’s largest managed-care organization.

In addition to being headquartered in California and only a few hours from the state capital, Kaiser Permanente has made it a point to contribute to the health-related welfare of California residents in programs that benefit all Californians, not just Kaiser members.

According to a recent news story,

“In 2020, KP gave $25 million to one of Newsom’s key initiatives, a state homelessness fund to move people off the streets and into hotel rooms, according to a KHN analysis of charitable payments filed with the California Fair Political Practices Commission. The same year, it donated $9.75 million to a state covid relief fund.”

However, the same story relates that a special arrangement that allows Kaiser Permanente to limit Medi-Cal (California’s Medicaid health care program) enrollment primarily to its previous enrollees, except in the case of foster kids and people who are eligible for both Medicare and Medi-Cal.

Opponents to this deal include other managed-care insurance plans in Medi-Cal who have argued that they are at risk of losing hundreds of thousands of patients and millions of dollars a year as a result.

In a recent Kaiser press release, the managed-care health giant announced an expanded portfolio of virtual plan options for 2022. These include a new small business employer plans through their Virtual Forward for Small Group and plans for individuals and families through their KPIF program.

Kaiser Permanente in 2022: What is Still Great

Kaiser has had its share of worker strikes, lawsuits, and difficulties with other managed-care providers, but it is still considered one of the best health plans out there by a majority of its members.

As personal finance website ValuePenguin relates,

“Kaiser Permanente has consistently received top ratings for its individual insurance and Medicare plans, often ranking far ahead of any competitors. It has a unique model of having insurance and medical care as branches of the same company. This is great for those who want a streamlined experience between health insurance and health care, but these policies are not a good fit for those who want flexibility when choosing their health care providers.”

The website’s review of Kaiser Permanente goes on to note that Kaiser has repeatedly been named as one of the best health insurance providers in the country. Both HealthCare.gov and Medicare.gov give Kaiser’s plans rankings of 4 to 5 stars. This is consistently higher than most other major insurance companies operating in the United States.

Another great benefit for many members is that their insurance coverage works hand-in-hand with all of Kaiser’s hospitals and medical centers. This means a much more streamlined approach for your claims and coverage process.

This also allows Kaiser’s to keep their costs low so that it can offer its members affordable plans.

However, it is both the comprehensive managed-care aspect and its limited coverage that represent real downsides for many who would prefer to have Kaiser Permanente for their health coverage.

Along with being limited to just those members living in eight states and the District of Columbia, another one of the biggest downsides of Kaiser health insurance is that most of their plans have no out-of-network coverage except in the case of urgent care visits or emergencies.

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