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Microsoft provides comprehensive medical coverage for you and your eligible dependents with zero paycheck premiums. The Kaiser Permanente HMO Plan is designed to offer personalized and coordinated care, along with cost predictability, to simplify managing your health. The Kaiser Permanente HMO plan is only available to employees and their dependents residing in California.
For Corporate employees
You are eligible to participate in the Kaiser Permanente HMO Plan if you are a full- or part-time employee on the Microsoft U.S. payroll and live in California. For additional details, review the full definition of an eligible employee and the explanation of workers who are not eligible for coverage.
For Retail employees
Retail employees are not eligible for the Kaiser Permanente HMO Plan. For additional details, review the full definition of an eligible employee and the explanation of workers who are not eligible for coverage.
For Interns & Visiting Researchers
You are eligible to participate in the Kaiser Permanente HMO Plan if you are a Microsoft intern or a visiting researcher and live in California. For additional details, please review the full definition of an eligible employee and the explanation of workers who are not eligible for coverage
Eligible dependents
When you sign up for medical coverage, you can also enroll eligible dependents including your:
Ineligible Dependents
The following are not eligible to participate in the Plan as a dependent:
Legally separated or divorced spouse
Parents, siblings, nieces, nephews, grandchildren, and grandparents
Roommates
Foster children
Any person who is on active duty in the armed forces
Anyone for whom you fail to provide proof of eligible status
No duplicate coverage
If both you and your spouse or domestic partner are employed by Microsoft and are eligible for benefit coverage, you are only allowed to be covered under one plan. You can either enroll as a dependent under your spouse or eligible domestic partner's plan or enroll in your own separate coverage, but not both. Your eligible children must be enrolled under only one employee's coverage.
Important Note: If you have other coverage, learn how Coordination of Benefits (COB) applies to you and your enrolled dependents.
With the Kaiser Permanente HMO Plan, there is no annual deductible and most services have a copay. The Plan covers preventive care at 100%. Except in the case of emergencies, coverage is generally limited to care received within the Kaiser Permanente network (including prescriptions). You choose a Kaiser Permanente provider; except in emergencies, all services must be provided at a Kaiser Permanente facility or contracted provider.
Here’s a quick breakdown:
| Kaiser Permanente California network | |
| Annual deductibl | None |
| Copays | $20 primary care visit $40 specialist visit $75 emergency room (waived if admitted) $150 ambulance $100 hospital outpatient |
| Annual out-of-pocket maximum | $1,500 per person; $4,500 per family (Infertility treatment does not count toward the annual out-of-pocket maximum) |
| Out of network care | Emergency only |
There is no overall annual or lifetime maximum in the Kaiser Permanente HMO Plan. However, annual, lifetime, and other benefit maximums apply to certain benefits. Check out the Evidence of Coverage on the Plan Documents page for a full list of what’s covered, as well as exclusions and limitations.
Kaiser makes it easy to get the care you need when you need it. For urgent needs that aren’t life threatening, you can talk with a clinician anytime, night or day, or have an on-demand online visit. You can also send messages to your doctor directly and schedule appointments online or through the Kaiser Permanente app. Check out all your care options for Kaiser Northern California or Kaiser Southern California.
The Kaiser Permanente HMO Plan provides comprehensive medical coverage. Here’s a snapshot of the most commonly used benefits but be sure to reference the Summary Plan Description for full details.
| Benefit | Coverage |
| Acupuncture services (medically necessary) | 100% after $40 copay per visit |
| Ambulance | 100% after $150 copay |
| Autism therapy | Individual visit: 100% after $20 copay per visit Group visit: 100% after $10 copay per visit |
| Chiropractic services | Not covered |
| Contraception | 100% |
| Diabetes health education | 100% |
| Diagnostic X-ray and lab | 100% after $10 copay per encounter |
| Durable medical equipment | 100% |
| Emergency room care | 100% after $75 copay per visit to any emergency facility (copay waived if admitted) |
| Hearing care and hardware | Exams: 100% Hardware: 100% up to $10,500 hardware limit per individual every 36 months |
| Hospice | 100% through the Kaiser Permanente Hospice Program |
| Hospital - inpatient | 90% |
| Hospital - outpatient | 100% after $100 copay per visit |
| Infertility | 50% (does not count toward annual out-of-pocket maximum) |
| Maternity care – inpatient/outpatient | Outpatient: 100% after $20 copay per visit Inpatient: 90% |
| Maternity virtual support | Free virtual care and on-demand support through Maven Clinic |
| Mental health and substance abuse treatment - inpatient/outpatient | Outpatient: 100% after $20 copay per visit| Inpatient: 90% |
| Mental health outpatient services through Spring Health (MS CARES employee assistance program) | 100% (Up to 24 sessions per calendar year) |
| Office visits | Primary care: 100% after $20 copay per visit Specialist care: 100% after $40 copay per visit |
| Prescription drugs | Value-based generic: 100% Generic: 100% after $10 copay Brand: 100% after $25 copay |
| Preventive care (services and prescription drugs) | 100% |
| Skilled nursing facility | 90% up to 100 days per participant per calendar year at a Kaiser Permanente-approved facility |
| Urgent care | 100% after $20 copay |
| Vision | 100% - Routine eye exams with a Plan optometrist |
Prescriptions can be filled only at Kaiser Permanente pharmacies. If you take medications on an ongoing basis, Kaiser Permanente also has a mail-order option that delivers medications to your home. Your prescription copay depends on the tier your medication falls under: value, generic, or brand. Preventive prescription drugs are covered in full. Prescription drugs may be subject to quantity limits and/or prior authorization. Check out the Kaiser Permanente HMO Plan formulary for all the details.
Ask questions about benefits coverage, find a provider, order a replacement card, or more | Kaiser Permanente Group number (No. California) 603873 |
Ask questions or learn about COBRA coverage for you or your eligible dependents | Microsoft COBRA Service Center |