Regional Medical Options
Based on where you live, you might be eligible to enroll in a regional medical option.
February 16, 2026
Overview
These regional medical options are available in certain areas of the country. If any of these options are available to you, you will see them listed when you log in to the enrollment website:
Prescription Drug Coverage
If you elect a regional medical option, prescription drug coverage is provided through the medical vendor — not CVS Caremark. If you have questions about prescription drug coverage, please contact the applicable medical vendor.
2026 Regional Medical Program Options
Kaiser Permanente Options — California
Medical
Kaiser HSAMedical
Annual Deductible
Individual: $4,500
Family: $4,500 Embedded
Amounts listed are per person. The per family amounts are $9,000 deductible and $12,500 out-of-pocket maximum.
Family: $4,500 Embedded
Amounts listed are per person. The per family amounts are $9,000 deductible and $12,500 out-of-pocket maximum.Annual Out-of-Pocket Maximum
Individual: $6,250
Family: $6,250 EmbeddedAmounts listed are per person. The per family amounts are $9,000 deductible and $12,500 out-of-pocket maximum.
Family: $6,250 Embedded
Amounts listed are per person. The per family amounts are $9,000 deductible and $12,500 out-of-pocket maximum.Coinsurance
40%
Physician Care Office Visits
PCP: $40 after deductible
Specialist: $50 after deductible
Preventive Care: 0%
Specialist: $50 after deductible
Preventive Care: 0%
General Hospital Services
Lab: 40% after deductible
X-Ray: 40% after deductible
Diagnostic: 40% after deductible
X-Ray: 40% after deductible
Diagnostic: 40% after deductible
Hospital Services
Inpatient: 40% after deductible
Outpatient: 40% after deductible
Outpatient: 40% after deductible
Emergency Services
ER: $250 after deductible
Urgent Care: $40 after deductible
Urgent Care: $40 after deductible
Mental Health/Substance Abuse
Inpatient: 40% after deductible
Office Visit: $40 after deductible
Office Visit: $40 after deductible
Kaiser HSAMedical
Annual DeductibleIndividual: $4,500
Family: $4,500 EmbeddedAmounts listed are per person. The per family amounts are $9,000 deductible and $12,500 out-of-pocket maximum.
Family: $4,500 Embedded
Amounts listed are per person. The per family amounts are $9,000 deductible and $12,500 out-of-pocket maximum.Annual Out-of-Pocket MaximumIndividual: $6,250
Family: $6,250 EmbeddedAmounts listed are per person. The per family amounts are $9,000 deductible and $12,500 out-of-pocket maximum.
Family: $6,250 Embedded
Amounts listed are per person. The per family amounts are $9,000 deductible and $12,500 out-of-pocket maximum.Coinsurance40%
Physician Care Office VisitsPCP: $40 after deductible
Specialist: $50 after deductible
Preventive Care: 0%
Specialist: $50 after deductible
Preventive Care: 0%
General Hospital ServicesLab: 40% after deductible
X-Ray: 40% after deductible
Diagnostic: 40% after deductible
X-Ray: 40% after deductible
Diagnostic: 40% after deductible
Hospital ServicesInpatient: 40% after deductible
Outpatient: 40% after deductible
Outpatient: 40% after deductible
Emergency ServicesER: $250 after deductible
Urgent Care: $40 after deductible
Urgent Care: $40 after deductible
Mental Health/Substance AbuseInpatient: 40% after deductible
Office Visit: $40 after deductible
Office Visit: $40 after deductible
Rx
Kaiser HSAPrescription Drug
Annual Deductible
Combined Deductible
Generic
Retail: $15
Mail Order: $30
Mail Order: $30
Formulary
Retail: $35
Mail Order: $70
Mail Order: $70
Non-Formulary
Retail: $35
Mail Order: $70
Mail Order: $70
Specialty
Retail: 30% up to $250
Mail Order: N/A
Mail Order: N/A
Kaiser HSAPrescription Drug
Annual DeductibleCombined Deductible
GenericRetail: $15
Mail Order: $30
Mail Order: $30
FormularyRetail: $35
Mail Order: $70
Mail Order: $70
Non-FormularyRetail: $35
Mail Order: $70
Mail Order: $70
SpecialtyRetail: 30% up to $250
Mail Order: N/A
Mail Order: N/A
Kaiser Permanente Options — Mid-Atlantic States
Medical
Kaiser HSAMedical
Annual Deductible
Individual: $4,500
Family: $4,500 EmbeddedAmounts listed are per person. The per family amounts are $9,000 deductible and $12,500 out-of-pocket maximum.
Family: $4,500 Embedded
Amounts listed are per person. The per family amounts are $9,000 deductible and $12,500 out-of-pocket maximum.Annual Out-of-Pocket Maximum
Individual: $6,250
Family: $6,250 EmbeddedAmounts listed are per person. The per family amounts are $9,000 deductible and $12,500 out-of-pocket maximum.
Family: $6,250 Embedded
Amounts listed are per person. The per family amounts are $9,000 deductible and $12,500 out-of-pocket maximum.Coinsurance
40%
Physician Care Office Visits
PCP: $50 after deductible
Specialist: $50 after deductible
Preventive Care: 0% after deductible
Specialist: $50 after deductible
Preventive Care: 0% after deductible
General Hospital Services
Lab: 40% after deductible
X-Ray: 40% after deductible
Diagnostic: 40% after deductible
X-Ray: 40% after deductible
Diagnostic: 40% after deductible
Hospital Services
Inpatient: 40% after deductible
Outpatient: 40% after deductible
Outpatient: 40% after deductible
Emergency Services
ER: $250 after deductible
Urgent Care: $50 after deductible
Urgent Care: $50 after deductible
Mental Health/Substance Abuse
Inpatient: 40% after deductible
Office Visit: $50 after deductible
Office Visit: $50 after deductible
Kaiser HSAMedical
Annual DeductibleIndividual: $4,500
Family: $4,500 EmbeddedAmounts listed are per person. The per family amounts are $9,000 deductible and $12,500 out-of-pocket maximum.
Family: $4,500 Embedded
Amounts listed are per person. The per family amounts are $9,000 deductible and $12,500 out-of-pocket maximum.Annual Out-of-Pocket MaximumIndividual: $6,250
Family: $6,250 EmbeddedAmounts listed are per person. The per family amounts are $9,000 deductible and $12,500 out-of-pocket maximum.
Family: $6,250 Embedded
Amounts listed are per person. The per family amounts are $9,000 deductible and $12,500 out-of-pocket maximum.Coinsurance40%
Physician Care Office VisitsPCP: $50 after deductible
Specialist: $50 after deductible
Preventive Care: 0% after deductible
Specialist: $50 after deductible
Preventive Care: 0% after deductible
General Hospital ServicesLab: 40% after deductible
X-Ray: 40% after deductible
Diagnostic: 40% after deductible
X-Ray: 40% after deductible
Diagnostic: 40% after deductible
Hospital ServicesInpatient: 40% after deductible
Outpatient: 40% after deductible
Outpatient: 40% after deductible
Emergency ServicesER: $250 after deductible
Urgent Care: $50 after deductible
Urgent Care: $50 after deductible
Mental Health/Substance AbuseInpatient: 40% after deductible
Office Visit: $50 after deductible
Office Visit: $50 after deductible
Rx
Kaiser HSAPrescription Drug
Annual Deductible
Combined Deductible
Generic
Retail: $20
Mail Order: $40
Mail Order: $40
Formulary
Retail: $50
Mail Order: $100
Mail Order: $100
Non-Formulary
Retail: 50%
Mail Order: 50%
Mail Order: 50%
Specialty
Retail: 50% up to $150
Mail Order: N/A
Mail Order: N/A
Kaiser HSAPrescription Drug
Annual DeductibleCombined Deductible
GenericRetail: $20
Mail Order: $40
Mail Order: $40
FormularyRetail: $50
Mail Order: $100
Mail Order: $100
Non-FormularyRetail: 50%
Mail Order: 50%
Mail Order: 50%
SpecialtyRetail: 50% up to $150
Mail Order: N/A
Mail Order: N/A
Kaiser Permanente Options — Oregon
Medical
Kaiser HSAMedical
Annual Deductible
Individual: $4,000
Family: $4,000 EmbeddedAmounts listed are per person. The per family amounts are $8,000 deductible and $13,300 out-of-pocket maximum.
Family: $4,000 Embedded
Amounts listed are per person. The per family amounts are $8,000 deductible and $13,300 out-of-pocket maximum.Annual Out-of-Pocket Maximum
Individual: $6,650
Family: $6,650 EmbeddedAmounts listed are per person. The per family amounts are $8,000 deductible and $13,300 out-of-pocket maximum.
Family: $6,650 Embedded
Amounts listed are per person. The per family amounts are $8,000 deductible and $13,300 out-of-pocket maximum.Coinsurance
40%
Physician Care Office Visits
PCP: 40% after deductible
Specialist: 40% after deductible
Preventive Care: 0% after deductible
Specialist: 40% after deductible
Preventive Care: 0% after deductible
General Hospital Services
Lab: 40% after deductible
X-Ray: 40% after deductible
Diagnostic: 40% after deductible
X-Ray: 40% after deductible
Diagnostic: 40% after deductible
Hospital Services
Inpatient: 40% after deductible
Outpatient: 40% after deductible
Outpatient: 40% after deductible
Emergency Services
ER: 40% after deductible
Urgent Care: 40% after deductible
Urgent Care: 40% after deductible
Mental Health/Substance Abuse
Inpatient: 40% after deductible
Office Visit: 40% after deductible
Office Visit: 40% after deductible
Kaiser HSAMedical
Annual DeductibleIndividual: $4,000
Family: $4,000 EmbeddedAmounts listed are per person. The per family amounts are $8,000 deductible and $13,300 out-of-pocket maximum.
Family: $4,000 Embedded
Amounts listed are per person. The per family amounts are $8,000 deductible and $13,300 out-of-pocket maximum.Annual Out-of-Pocket MaximumIndividual: $6,650
Family: $6,650 EmbeddedAmounts listed are per person. The per family amounts are $8,000 deductible and $13,300 out-of-pocket maximum.
Family: $6,650 Embedded
Amounts listed are per person. The per family amounts are $8,000 deductible and $13,300 out-of-pocket maximum.Coinsurance40%
Physician Care Office VisitsPCP: 40% after deductible
Specialist: 40% after deductible
Preventive Care: 0% after deductible
Specialist: 40% after deductible
Preventive Care: 0% after deductible
General Hospital ServicesLab: 40% after deductible
X-Ray: 40% after deductible
Diagnostic: 40% after deductible
X-Ray: 40% after deductible
Diagnostic: 40% after deductible
Hospital ServicesInpatient: 40% after deductible
Outpatient: 40% after deductible
Outpatient: 40% after deductible
Emergency ServicesER: 40% after deductible
Urgent Care: 40% after deductible
Urgent Care: 40% after deductible
Mental Health/Substance AbuseInpatient: 40% after deductible
Office Visit: 40% after deductible
Office Visit: 40% after deductible
Rx
Kaiser HSAPrescription Drug
Annual Deductible
Combined Deductible
Generic
Retail: $15
Mail Order: $30
Mail Order: $30
Formulary
Retail: $30
Mail Order: $60
Mail Order: $60
Non-Formulary
Retail: $50
Mail Order: $100
Mail Order: $100
Specialty
Retail: 50%
Mail Order: N/A
Mail Order: N/A
Kaiser HSAPrescription Drug
Annual DeductibleCombined Deductible
GenericRetail: $15
Mail Order: $30
Mail Order: $30
FormularyRetail: $30
Mail Order: $60
Mail Order: $60
Non-FormularyRetail: $50
Mail Order: $100
Mail Order: $100
SpecialtyRetail: 50%
Mail Order: N/A
Mail Order: N/A
Kaiser Permanente Options — Washington
Medical
Kaiser HSAMedical
Annual Deductible
Individual: $4,500
Family: $7,350
Family: $7,350
Annual Out-of-Pocket Maximum
Individual: $6,000
Family: $7,350
Family: $7,350
Coinsurance
30%
Physician Care Office Visits
PCP: 30% after deductible
Specialist: 30% after deductible
Preventive Care: 0%
Specialist: 30% after deductible
Preventive Care: 0%
General Hospital Services
Lab: 30% after deductible
X-Ray: 30% after deductible
Diagnostic: 30% after deductible
X-Ray: 30% after deductible
Diagnostic: 30% after deductible
Hospital Services
Inpatient: 30% after deductible
Outpatient: 30% after deductible
Outpatient: 30% after deductible
Emergency Services
ER: $75/visit after deductible
Urgent Care: 30% after deductible
Urgent Care: 30% after deductible
Mental Health/Substance Abuse
Inpatient: 30% after deductible
Office Visit: 30% after deductible
Office Visit: 30% after deductible
Kaiser HSAMedical
Annual DeductibleIndividual: $4,500
Family: $7,350
Family: $7,350
Annual Out-of-Pocket MaximumIndividual: $6,000
Family: $7,350
Family: $7,350
Coinsurance30%
Physician Care Office VisitsPCP: 30% after deductible
Specialist: 30% after deductible
Preventive Care: 0%
Specialist: 30% after deductible
Preventive Care: 0%
General Hospital ServicesLab: 30% after deductible
X-Ray: 30% after deductible
Diagnostic: 30% after deductible
X-Ray: 30% after deductible
Diagnostic: 30% after deductible
Hospital ServicesInpatient: 30% after deductible
Outpatient: 30% after deductible
Outpatient: 30% after deductible
Emergency ServicesER: $75/visit after deductible
Urgent Care: 30% after deductible
Urgent Care: 30% after deductible
Mental Health/Substance AbuseInpatient: 30% after deductible
Office Visit: 30% after deductible
Office Visit: 30% after deductible
Rx
Kaiser HSAPrescription Drug
Annual Deductible
Combined Deductible
Generic
Retail: $15
Mail Order: $45
Mail Order: $45
Formulary
Retail: $30
Mail Order: $90
Mail Order: $90
Non-Formulary
Retail: N/A
Mail Order: N/A
Mail Order: N/A
Specialty
Retail: Contact Kaiser
Mail Order: N/A
Mail Order: N/A
Kaiser HSAPrescription Drug
Annual DeductibleCombined Deductible
GenericRetail: $15
Mail Order: $45
Mail Order: $45
FormularyRetail: $30
Mail Order: $90
Mail Order: $90
Non-FormularyRetail: N/A
Mail Order: N/A
Mail Order: N/A
SpecialtyRetail: Contact Kaiser
Mail Order: N/A
Mail Order: N/A
Contact Information
Dean Health
1-800-279-1301
Kaiser Permanente California
1-800-464-4000
Kaiser Permanente Mid-Atlantic States
DC Metro: 301-468-6000
Outside DC Metro: 1-800-777-7902
Kaiser Permanente Northwest
1-800-813-2000
Kaiser Permanente Washington
1-888-901-4636
Coverage Transparency
The federal Transparency in Coverage rule requires our group health plan to publicly share detailed price and cost-sharing information starting July 1, 2022. The Rule requires health plans to post machine readable files (MRFs) that show the negotiated rates for in-network providers and the allowed amounts for out-of-network providers, for certain services covered by the group health plan. Each of our health plan insurers and third-party administrators will publish the MRFs online and update them each month at the following links:
Note that MRFs are formatted to allow third parties, such as researchers, regulators and app developers, to more easily access and analyze data about health care costs and may be difficult for others to review.