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April 1, 2011 through March 31, 2012
Kaiser Permanente Child Health Plan is a quality health plan at an affordable price. If your child qualifies, coverage includes the following:
Benefit
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Copayment
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Doctor office visits
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$5
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Prescriptions
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$5 generic (100-day supply)
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Urgent care
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$5
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Emergency visits
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$35
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Hospital care
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No charge
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Hearing and vision tests
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No charge
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Laboratory/X-ray services
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No charge
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Mental health care
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Outpatient: $5 per individual therapy visit; up to 20 visits per calendar year
Inpatient: no charge; up to 30 days per calendar year
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Eyeglasses
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$125 allowance for pair of eyeglasses every 24 months
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Copayment maximum
per calendar year
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$250 per child/$500 for two or more children
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Dental coverage for Kaiser Permanente Child Health Plan is offered to all our Child Health Plan members at no additional premium. The DeltaCare program is administered by PMI, the HMO affiliate of Delta Dental.
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