In addition to the three national Medical Plan options — Options A, B and C — you may choose an HMO option through Kaiser. If you elect the HMO option, you will be enrolled in coverage based on your ZIP code, either Northern or Southern California.
What’s new for the Kaiser California HMO option in 2016:
- Residential treatment for mental health and chemical dependency: Coverage for care in a skilled nursing facility for medical and surgical diagnosis will be expanded to include coverage for mental health and chemical dependency.
- Contraceptive products and services: Over-the-counter contraceptives will now be covered under the plan when prescribed by a plan provider.
- Expanded coverage for hospice care and outpatient rehabilitative therapy: Hospice eligibility requirements have been redefined from a six-month life expectancy to a 12-month life expectancy. The 60-visit annual limit on outpatient rehabilitative and multidisciplinary therapy visits has been removed. There will now be no annual limit.
- Autism spectrum disorders: The plan will provide coverage for the diagnosis and treatment of autism spectrum disorders, including Applied Behavioral Analysis (ABA) Therapy. The treatment for autism must be coordinated with your primary care provider. Contact Kaiser for further details regarding coverage.
For a plan design chart, see the California Medical Coverage Options.