Kaiser Permanente Northwest
Whether you’re signing up for the first time or or already enrolled, we encourage you to take advantage of the affordable, high-quality healthcare available to you as a caregiver.
KPNW Health Plan Highlights
Beyond preventive care, your coverage includes many ways to get care and support, like wellness coaching and personalized management programs for chronic conditions.
Learn about the key benefits of your plan and download your KPNW Plan Details.
Plan details effective August 1, 2025.
Medical & Preventive Care
Free Primary Care Visits
There is no cost* to see your primary care provider (PCP). You can see your PCP for wellness check-ups and when you’re sick. Your coverage also includes virtual care options, so you can get care from the comfort of home.
*Visits with your PCP have no co-pay, however if your doctor orders tests or lab work, you may have to pay a co-pay on those services.
Low-Cost Urgent and Emergency Care
Urgent care is a low-cost option for non-emergency issues like minor injuries or flu symptoms when your doctor isn’t available. Emergency room visits should be used for serious conditions like chest pain, difficulty breathing or severe injuries.
A deductible or co-pay may apply.
Medical Visit Co-pays (in-network) | |
|---|---|
Primary Care Provider / Online Visits | $0 Co-Pay |
Urgent Care Visits | $30 Co-Pay |
Emergency Room Visits | $200 Co-Pay |
Specialty Visits | $15 Co-Pay |
Prescription Benefits
Prescription medication (Rx)
Prescription medication (Rx) benefits are included in your coverage and transferring your prescriptions is simple! Just sign into your Kaiser Permanente online account or call Member Services.
Mail order is the most affordable option. You can fill your prescriptions online, by phone or with the Kaiser Permanente app.
Insulin: $0 generic/$0 preferred brand/$0 non-preferred brand
Inhalers & EPI Pens: $5 generic/$25 preferred brand
Rx Co-pays | Pharmacy 30-day supply | Mail Order 90-day supply |
|---|---|---|
Generic Contraceptives* | $0 | $0 |
Value-Based Drugs** | $5 | $10 |
Preferred Brand | $25 | $50 |
Non-Preferred | $50 | $100 |
*If you work for a religious-based organization, your health plan excludes contraceptive coverage as permitted under the religious exemption of the Affordable Care Act. However, you will receive these at no cost to you (and without taking any additional action) from Kaiser Permanente, as long as you are enrolled in a health plan. **Value-based drugs are generic medications for treating various health conditions.
Additional Benefits
Mental Health
Get help navigating major life events or managing issues like stress or depression. Kaiser Permanente provides comprehensive support, including:
Professional care, medication, group therapy and more.
Access to free apps like Calm (for mindfulness) and Headspace Care (for one-on-one coaching).
- Virtual assessments and e-visits to review your symptoms and get options that are right for you.
Call 1-888-287-2680, Monday through Friday, 8 a.m. to 5 p.m. KPNW can match you with a mental health specialist in your area or help you find addiction treatment.
Mental Health Visits
Outpatient: $0 co-pay
Inpatient: $100 co-pay, per day for up to 5 days per admit. Pre-authorization required or will not be covered.
Vision
Get comprehensive eye care, including one free eye exam and $600 for vision hardware (like lenses, frames and contacts) every 12 months. Choose from a wide selection of quality eyewear to match your style and budget—plus, enjoy free adjustments and repairs anytime.
Members age 19 and over: $600 per 12 months
Members under 19: No charge for eyeglass lenses or frames or contact lenses every 12 months
Wellness Coaching & Programs
Wellness coaching is available at no cost and doesn’t require a referral. Get one-on-one support from a wellness coach to help you eat healthier, reduce stress, stay active, manage your weight, quit smoking and more.
If you’re managing a chronic condition like diabetes or high blood pressure, your plan also includes personalized care team support (referral required) and easy-to-use apps and programs.
Learn more about wellness coaching or call 1-855-632-8280 to make an appointment with a wellness coach. Interpretation services are available.
Massage, Chiropractic & Acupuncture
Chiropractic and acupuncture therapy are available at a $0 co-pay. Visit limits apply. See plan details.
Massage therapy is available a $25 co-pay for up to 12 self-referred visits per year. See plan details.
These services can help treat and prevent muscle and joint pain. Be sure to confirm your provider accepts your insurance when scheduling.
Naturopathy
Naturopathy visits: $0 co-pay.
Naturopathy uses natural remedies like nutrition, and lifestyle changes to support your health.
Physical Therapy
Physical therapy is available for a $15 co-pay per visit.
Visit limits apply and referral is required. See plan details.
Physical therapy can help you recover from injury, manage pain, and improve movement. Request a referral through your Kaiser Permanente Member Portal or call Member Services.
After your visit, you’ll get free access to MedBridge, a physical therapy app with a personalized exercise and stretching program tailored to your goals and ability.
Reproductive Health
Reproductive Health Visits are a $0-$15 co-pay per visit.
Preventative visits are a $0 co-pay. Other co-pay amounts depend on the diagnosis coding.
Contraceptives are available for a $0 co-pay*.
$0 co-pay for FDA-approved prescription and over-the-counter contraceptive drugs, devices and products.
Abortion Services are a $0 co-pay
for both in and out of network, inpatient and outpatient settings as well as medication. (Covered service in any setting)
*If you work for a religious-based organization, your health plan excludes contraceptive coverage as permitted under the religious exemption of the Affordable Care Act. However, you will receive these at no cost to you (and without taking any additional action) from Kaiser Permanente, as long as you are enrolled in a health plan.
Gender-Affirming Care
Kaiser Permanente offers inclusive, gender-affirming care in a safe, supportive environment. Services include hormone therapy, mental health support, surgical procedures, and care for children and teens.
Expanded Coverage
KPNW is your primary medical plan, but your healthcare coverage also includes these additional benefits:
Choice of Dental Coverage
You can choose from two dental plans and decide which one is best for you. Both options include routine exams, orthodontia benefits and broad provider networks.
Use the chart to compare plans and review your potential out-of-pocket costs for common services in the plan summaries.
 |  | |
|---|---|---|
Annual Maximum Benefit | $5,000 | None |
Deductible | $0 | $0 |
Routine Exams | Covered In Full | Covered In Full |
Orthodontia Benefits | Yes | Yes |
Provider Network | Delta Dental has a broad network of providers, including in rural areas. You’ll want to find a Delta Dental PPO dentist to maximize your benefit. | Willamette Dental has many convenient locations in western Washington, making it easy to find a Willamette dentist if you live along the I-5 corridor. |
Find a Dentist Near You | 1-800-554-1907 DeltaDentalWA.com | 1-855-433-6825 willamettedental.com |
Hearing Benefits
Through EPIC Hearing, you and your kids can get a no-cost annual hearing exam with consultation from an in-network provider and up to $3,000 of hearing hardware with extended warranty per ear every 36 months.
Family-building, Reproductive & Midlife Care
Get benefits for every stage of life, from fertility and family-building to pregnancy, postpartum and menopause. Get coverage for the latest treatments, personalized support from dedicated Patient Care Advocates (PCAs) and in-person or virtual care. And now you can get up to $15,000 for adoption-related expenses (lifetime benefit).
KPNW Plan Details
See a full breakdown of your medical and dental plans, including out-of-pocket costs, benefits, and coverage for prescriptions, visits and treatments.
Common Terms
Learn the definitions of common insurance terms to help you better understand your plan benefits.
Resources and Support
Health Benefits Customer Service
Get help with questions about coverage, eligibility, applying and more.
Customer service is available Monday-Friday, 8 a.m. to 6 p.m.
1-877-606-6705
In-language support available.
Live Chat Support
Log in to your Health Benefits Account for chat support.
SEIU775BG-caregiver@magnacare.com
Can’t contact customer service during business hours?
Email and get a response within 2 business days.
Kaiser Permanente Northwest
New Member Services:
1-888-491-1124
myseiu.be/kp-new-member
Member Services:
1-888-813-2000
myseiu.be/kp-member
Mental Health Services
1-855-632-8280
myseiu.be/kpnw-bh
Nurse Helpline
1-800-324-8010
myseiu.be/kp-nurse
Member Language Assistance
1-888-813-2000
myseiu.be/kp-language
Dental
Delta Dental
1-800-554-1907
deltadentalwa.com
Willamette Dental
1-855-433-6825
myseiu.be/willamette
Other Benefits
EPIC Hearing
1-866-956-5400
myseiu.be/epic
Progyny (Fertility and Family-building)
1-877-363-5638
myseiu.be/progyny
In-language Support
Contact Health Benefits Customer Service and you’ll be connected to someone who speaks your language and can help you apply for and manage your benefits.
After enrollment, language support is available through KPWA member services.
Manage Your Health Benefits with an Online Account
- View hours and eligibility for health benefits.
- Apply for or make changes to healthcare coverage.
- Access plan documents and forms.
- Sign up for email communications about coverage.
Health Benefits Support
Get help with coverage, eligibility, applying and more by visiting the support page or calling Customer Service at 1-877-606-6705.
Coverage for Kids
If you work 120 hours or more per month, your kids get all the same great benefits you do, including emotional well being, orthodontia, wellness visits and much more.
Healthcare Coverage Eligibility
Learn about how to qualify for healthcare coverage for you or your kids and how the hours you work effect your coverage.
Common Healthcare Coverage Terms
Learn the definitions of common insurance terms and definitions to better understand your insurance plan.