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Child
Health Plan
Eligibility
Benefits
Questions
Resources
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Summary
of benefits
January 1, 2007, through December 31, 2007
Kaiser Permanente Child Health Plan is a quality
health plan at an affordable price. If your child qualifies, coverage
includes:
| Benefit |
Copayment |
| Doctor
office visits |
$5 |
| Prescriptions |
$5
generic/$20 brand name (100-day supply) |
| Urgent
care |
$5 |
| Emergency
visits |
$35 |
| Hospital
care |
No
charge |
| Hearing
and vision tests |
$5 |
| Laboratory/X-ray
services |
No
charge |
| Mental
health care |
| 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 |
$125
allowance for pair of eyeglasses every 24 months |
| Copayment
maximum
per calendar year
|
$250
per child/$500 for two or more children |
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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