The 2018 Medical Plans

There are two plan choices for retirees living outside of California: Kaiser Permanente HMO and UnitedHealthcare PPO.

What’s New in 2018

Retirees will now have the option of selecting a Kaiser Permanente health plan in three other Kaiser regions, including Kaiser’s Northwest, Washington and Hawaii regions. For an overview of available locations, click here

For more information, please go to my.kp.org/ccsf.

Delta Dental PPO Increases Annual Benefit Maximum
The annual benefit maximum for Delta Dental PPO for Retirees will increase from $1,000 to $1,250 in 2018. The diagnostic and preventive services of two annual cleanings and two annual exams will not count toward this benefit maximum.

For more information, please visit Delta Dental's Summary of Benefits or deltadentalins.com/ccsf.

VSP Vision Care Adds a Premier Plan Choice

Pay a little more to enroll in the new VSP Premier Plan. You can get glasses every year with a $300 frame allowance or contact lenses every year with a $250 allowance. Anti-reflective and progressive lenses are covered in full with a $25 co-pay for each.

Visit sfhss.vspforme.com or call VSP at 1-800-400-4569.

 

Medical Plans at a Glance: Retirees With Medicare

HMO
 

An HMO (Health Maintentance Organization) offers benefits through a network of participating physicians, hospitals and providers. For non-emergency care, you access service through your Primary Care Physician or an urgent care center.

KAISER PERMANENTE HMO

KAISER PERMANENTE SENIOR ADVANTAGE

 
  • Must be eligible for Medicare Part B
  • Must live in Kaiser service area
  • In-network service only
  • Out-of-pocket, fixed co-pays
  • No deductible
  • One ID card for all your covered services and prescription drugs.
 

Your Medicare dependents who live in Kaiser service areas will be enrolled in Kaiser Permanente Senior Advantage.
Your non-Medicare dependents will be enrolled in Kaiser Permanente's Traditional HMO Plan.


KAISER PERMANENTE PLANS OUTSIDE OF
CALIFORNIA: RETIREES WITH MEDICARE
PPO
 

A PPO (Preferred Provider Organization) offers a wider choice of physicians because you can access service in-network or out-of-network. You are not assigned a Primary Care Physician so you have more responsibility for coordinating your care.

KAISER PERMANENTE HMO

UNITEDHEALTHCARE (MEDICARE ADVANTAGE PPO)

 
  • Must be eligible for Medicare
  • Live anywhere in the USA
  • One ID card for all your covered services and prescription drugs from a network of 67,000 pharmacies nationwide
  • Out-of-pocket; fixed co-pay
  • No deductible
  • Obtain service from any willing Medicare provider in the USA
 

Your non-Medicare dependents will be enrolled in the City Plan PPO. Blue Shield Plans are not available to members living outside of California.


UNITEDHEALTHCARE BENEFITS AT
A GLANCE: RETIREES WITH MEDICARE
 

Medical Plans at a Glance: Retirees Without Medicare

HMO
 

An HMO (Health Maintentance Organization) offers benefits through a network of participating physicians, hospitals and providers. For non-emergency care, you access service through your Primary Care Physician or an urgent care center.

KAISER PERMANENTE HMO

TRADITIONAL PLAN (NON MEDICARE HMO)

 
  • Must not be eligible for Medicare
  • Must live in Kaiser service area
  • In-network service only
  • Out-of-pocket, fixed co-pays
  • No deductible
 

Your Medicare dependents will be in
Kaiser Permanente Senior Advantage.




KAISER PERMANENTE BENEFITS AT A
GLANCE: RETIREES WITHOUT MEDICARE
PPO
 

A PPO (Preferred Provider Organization) offers a wider choice of physicians because you can access service in-network or out-of-network. You are not assigned a Primary Care Physician so you have more responsibility for coordinating your care.

CITY PLAN

UNITEDHEALTHCARE (NON MEDICARE PPO)

 
  • Must not be eligible for Medicare
  • Live anywhere in the world
  • Access covered services worldwide
  • Annual deductible must be reached before coverage begins
  • Out-of-pocket coinsurance %
  • Lower rate of employer coinsurance for out-of-network providers
  • Reasonable and customary fee reimbursement limits
 

Your non-Medicare dependents will be enrolled in the City Plan PPO. Blue Shield Plans are not available to members living outside of California.

UNITEDHEALTHCARE BENEFITS AT
A GLANCE: RETIREES WITHOUT MEDICARE