Kaiser Er Copay



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We’ve made changes to help lessen the chances you’ll come into contact with COVID-19.

Already scheduled an appointment? Visit the appointment waiting room.

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Urgent COVID-19 and flu problems

Open Monday through Friday, 7:30 a.m. to 7:30 p.m. and Saturday and Sunday, 8 a.m. to 5 p.m.

  • Marysville**
  • Shoreline*
  • Smokey Point*
  • Book a virtual visit. Call 1-425-257-1400.

These sites will ONLY see flu or COVID-19 symptoms.

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Kaiser Er Copay

For problems that are not COVID-19 or flu

Open Monday through Friday, 7:30 a.m. to 7:30 p.m., and Saturday and Sunday, 8 a.m. to 5 p.m.

  • Marysville**
  • Mill Creek
  • Shoreline*
  • Smokey Point**
  • Snohomish
Kaiser Er Copay

These sites will NOT see flu or COVID-19 symptoms.

*Kaiser Medicare Advantage HMO and Commercial HMO are out of network in King County.
**Kaiser Core and Medicare Advantage HMO are out of network at Marysville and Smokey Point.

Copay

Walk-in clinic or ER, what's the difference?

Kaiser Hospital Copay

    • Abdominal pain
    • Allergies
    • Asthma
    • Colds
    • Cough or upper respiratory symptoms
    • Ear or sinus pain
    • Fevers
    • Flu symptoms
    • Foreign object in nose
    • Headaches
    • Minor burns and bruises
    • Possible broken bones
    • Rash or hives
    • Scrapes and cuts
    • Sprains
    • Stings and bites
    • Urinary symptoms
    • Work-related injuries
  • Call 911 and seek emergency care for sudden or unexpected medical problems, like:

    • Amputation of limbs or deep wounds with severe bleeding
    • Chest pain (suspected heart attack or stroke)
    • Inhaled smoke or chemical
    • Major burns to the face or large areas of the body
    • Physical or sexual assault
    • Poisoning, overdoses and suicidal behavior
    • Pregnancy problems over 20 weeks, including labor, bleeding, fluid leaks or the fetus has stopped moving
    • Severe head injuries with loss of consciousness or new seizures
    • Sudden confusion, weakness, dizziness, numbness, severe headache or difficulty speaking or breathing
    • Vomiting blood

Walk-in clinic FAQs

  • It depends, and we’ll do our best to help you quickly. Typical waits are 15 minutes to an hour. Often, our walk-in clinics can see you faster than an emergency room. Schedule your spot or check the wait times before you go.

  • You’ll see one of our experts: a medical doctor, a nurse practitioner, a physician assistant or a doctor of osteopathic medicine. They have a great deal of skill and knowledge. Each one is devoted to making lives better through health and healing and doing what is right for each patient.

  • Check with your health plan for details and copay amounts. We bill urgent care visits as an office visit, not ER care. Walk-in clinic care tends to cost patients less than an ER visit.

    Use our price sheet to view current prices for primary care and walk-in clinic services. This includes physician visits, preventive visits, preventive screenings and other services.

  • If you’re in severe pain, call 911. If you’re not, the walk-in-clinic might be faster, more helpful and less costly. Your health information from the visit can be shared with your primary care doctor and any specialists as needed.

  • No, you can seek urgent care in our walk-in clinics, even if you don’t have a primary care provider (PCP). If you don’t have a PCP, we think it’s important to find one. We are happy to help you do so. You want a doctor who knows you and your unique health care needs. Everyone is different. For the best health, find yourself a PCP for annual visits.

  • Walk-in clinic visits are billed as office visits, not as ER or urgent care center visits. Please check with your health plan to find out how walk-in visits are covered.

COVID-19 FAQs

    • Congestion or runny nose
    • Cough
    • Diarrhea
    • Fatigue
    • Fever or chills
    • Headache
    • Muscle or body aches
    • Nausea or vomiting
    • New loss of taste or smell
    • Shortness of breath or difficulty breathing
    • Sore throat
  • If you have a higher chance of becoming very sick with COVID-19, you may want to stay home and book a virtual walk-in clinic visit instead. Can you answer “yes” to any of these?

    • Age 65 or older?
    • Severely overweight?
    • Have diabetes (whether you use insulin or not)?
    • Have asthma (moderate or severe)?
    • Have COPD, emphysema or other serious lung problem?
    • Have a serious heart problem?
    • Have kidney disease with dialysis?
    • Have liver disease?
    • Live in a nursing home or long-term care facility?
    • Have problems with your immune system?

    If you answered “yes,” think about booking a virtual visit. To book a virtual visit, call 1-425-257-1400.

This is a comparison of the copay medical plans for FY 2019-20 open enrollment. Please see the High Deductible Health Plan Comparison page as well.

Comparing network costs versus non-network costs between Kaiser Permanente and United Healthcare in the Co-Pay plans
United Healthcare (UHC) Copay Choice Plus PlanKaiser Permanente (KP) DHMO Plan
Annual DeductibleNetworkNon-NetworkAnnual DeductibleNetworkNon-Network
Individual$1,500$3,000Individual$750Not Covered
Family $3,000$6,000Family $1,500

Kaiser Copay Cost

Out of Pocket Max Comparison
Annual Out-of-Pocket Max: UHCAnnual Out-of-Pocket Max: KP
Annual DeductibleNetworkNon-NetworkAnnual DeductibleNetworkNon-Network
Individual$5,000$10,000Individual$2,000Not Covered
Family$10,000$20,000Family $4,000
Co-Insurance Comparison
Co-Insurance: UHCCo-Insurance: KP
Annual DeductibleNetworkNon-NetworkAnnual DeductibleNetworkNon-Network
Percentage you pay after you have satisfied your deductible.20%50%Percentage you pay after you have satisfied your deductible.10%Not Covered
Office Visit and Urgent Care Cost Comparison
Office Visits/Urgent Care (1): UHCOffice Visits/Urgent Care (1): KP
ServiceNetworkNon-NetworkServiceNetworkNon-Network
Preventative Care/ScreeningsNo Charge50% of eligible expenses after deductiblePreventative Care/ScreeningsNo ChargeNot Covered
Primary Care - Illness/Injury$30 CopayPrimary Care - Illness/Injury$30 Copay
Specialist$50 CopaySpecialist$50 Copay
Inpatient Hospital20% Co-insurance after $1,000 CopayInpatient Hospital10% Coinsurance
Urgent Care$75 CopayUrgent Care$75 Copay
Ambulance20% after deductibleAmbulance$500 Copay
Emergency Room$500 CopayEmergency Room
Virtual Visits
(Network Benefits are available only when services are delivered through a
Designated Virtual Network Provider.)
$30 CopayNot CoveredVirtual Care - Primary/Specialty
- Phone Visit, Video Visit
- Chat Online, Email, E-visits
No ChargeNot Covered

Kaiser Copayment Plans

Mental Health Benefits Comparison
Mental Health (1): UHCMental Health (1): KP
ServiceNetworkNon-NetworkServiceNetworkNon-Network
Inpatient (Hospitalization/Day Treatment)20% Co-insurance after $1,000 Copay50% of eligible expenses after deductibleInpatient (Hospitalization/Day Treatment)10% Coinsurance Not Covered
Outpatient (Therapy)$30 CopayOutpatient (Therapy)$30 Copay

Does Kaiser Cover Er Visits

Inpatient and Outpatient Addictive Disorders Services Comparison
Substance-Related & Addictive Disorders Services (1): UHCSubstance-Related & Addictive Disorders Services (1): KP
ServiceNetworkNon-NetworkServiceNetworkNon-Network
Inpatient20% Co-insurance after $1,000 Copay50% of eligible expenses after deductibleInpatient10% Coinsurance Not Covered
Outpatient (Therapy) $30 Copay Outpatient (Therapy)$30 Copay
Vision Benefits Comparison
Vision: UHCVision: KP
ServiceNetworkNon-NetworkServicePediatric
(up to end of month he/she turns age 19)
Adult
(members age 19 and over)
Up to 1 Routine Exam per plan year under the Medical Plan$50 Copay- Allowances apply to network providers only.
- Please refer to your plan details for out-of-network allowances
Optometrist/
Ophthalmologist
Optometrist: $30 Copay/ Ophthalmologist: $50 Copay
(Includes contact lens fitting up to $175)
Optical hardware - Frames $130 allowance OR
- Contact lens $150 allowance
Optical hardware- 10% Coinsurance
- 1 pair of glasses & lenses every 2 years or 2 years of contact lenses
$150 Credit once every 24 months towards optical hardware
Prescription Comparison
Prescription: UHCPrescription: KP (2)
Retail: 30-day supplyMail Order: 90-day supplyRetail: 30-day supplyMail Order: 90-day supply
Tier 1$10 Copay$20 CopayGeneric$10 Copay$20 Copay
Tier 2$30 Copay$60 CopayPreferred Brand Name$30 Copay$60 Copay
Tier 3$50 Copay$100 CopayNon-Preferred Brand NameApproved drugs covered at generic costshare
Specialty (30 day supply)20% up to $100Specialty20% up to $100

* Please refer to the official plan documents for detailed information and listing of covered services

  1. If a procedure is preformed during a Primary Care, Specialty Care, or Urgent Care Visit then the service is covered at coinsurance after deductible is met.
  2. For Southern Colorado Kaiser Permanente members: maintenance medications must be filled at a Pharmacy in a Kaiser Permanente medical office or through Kaiser Permanente mail order.

Kaiser Permanente Emergency Copay

Rates - Employee Monthly Contribution

What Does Er Copay Cover

United Healthcare Copay Choice Plus PlanKaiser Permanente DHMO Plan
Employee Only$159.14Employee Only$93.72
Employee + Spouse$437.52Employee + Spouse$298.02
Employee + Child(ren)$310.30Employee + Child(ren)$190.34
Family$638.86Family$440.48