Kaiser Permanente Individual Plans Review

On this page

• What Kaiser Permanente is and how its model works
• Where Kaiser sells individual plans
• What’s changing for 2027
• Quality ratings: where Kaiser stands out
• Complaints and a settlement to know about
• Pros and cons
• Frequently asked questions

What Kaiser Permanente is and how its model works

Kaiser Permanente isn’t a single insurance company the way Cigna or Oscar are. It’s Kaiser Foundation Health Plan, Inc. and a set of regional affiliated health plans, each usually paired with an exclusive Permanente Medical Group and, in most regions, Kaiser-owned hospitals. It’s a nonprofit, integrated model, not a publicly traded company, so there’s no stock ticker or investor earnings call to check. Because Kaiser both insures and largely delivers your care, its plans are HMO-style: you’ll generally see Permanente-employed physicians and use Kaiser facilities rather than choosing freely from a broad outside network. That can mean more coordinated care, but it also means confirming your specific doctors and hospital are inside Kaiser’s network matters more than it would with a broader PPO style plan; see what’s better, a PPO or an HMO for the general tradeoffs of this kind of plan design.

Where Kaiser sells individual plans

For 2026 and 2027, Kaiser’s individual Marketplace plans are sold in California, Colorado, Georgia, Hawaii, Nevada, Oregon, Washington, Maryland, Virginia and Washington, D.C., 9 states plus D.C. by Kaiser’s own count. That’s a narrower footprint than national insurers like UnitedHealthcare or Ambetter, but Kaiser holds a strong position within the regions it does serve; in Georgia, for instance, Kaiser is one of the insurers staying in Georgia Access for 2027 as Cigna and UnitedHealthcare leave. If you’re comparing costs, see how premiums run in California, Georgia or Virginia, since Kaiser’s own rates and plan designs differ by region too.

What’s changing for 2027

Open enrollment deadlines depend on your state’s exchange, not on Kaiser. On HealthCare.gov, 2027 open enrollment runs November 1, 2026 to January 15, 2027, while state-run exchanges set their own dates; California and D.C., for example, run through January 31. See when open enrollment starts and confirm the deadline with your state’s exchange. Kaiser’s member notices also point to federal changes that limit premium tax credits for some lawfully present immigrants, and to the rule that made all bronze and catastrophic Marketplace plans HSA-eligible. Kaiser says it gives members 60 days’ notice before a premium change takes effect.

Quality ratings: where Kaiser stands out

Kaiser’s quality scores are a genuine strength. NCQA’s September 2026 health plan ratings, covering nearly 1,000 commercial, Medicare Advantage and Medicaid plans nationally, gave out only 18 five-star ratings in total, and Kaiser plans earned 9 of them.

NCQA 2026 rating	Kaiser’s result
5-star plans awarded nationally	18 total; Kaiser holds 9
Kaiser plans rated 4.5 stars or higher	20 of 22 rated Kaiser plans (91%)
Kaiser Medicare plans rated 4.5+	All of them
5-star Commercial regions	Northern California, Mid-Atlantic States

Kaiser’s Northern California and Southern California Medicaid and Medicare plans, and its Mid-Atlantic States and Nevada Medicare plans, were also named among the 5-star group. You can look up any specific Kaiser regional plan’s current rating yourself at NCQA’s Report Cards site rather than relying on the national summary alone.

Complaints and a settlement to know about

To check complaint history for the Kaiser plan in your state, use the NAIC’s Consumer Insurance Search. One matter worth knowing about: the U.S. Department of Labor found that Kaiser’s California operations failed to provide timely, appropriate access to mental-health and substance-use-disorder care, citing inadequate behavioral-health provider networks and improper use of screening questionnaires to deny care. Kaiser agreed to pay $28.3 million to affected members plus a $2.8 million penalty to the federal government, covering conduct through 2023, with a claims process for members seeking reimbursement of out-of-network behavioral-health costs. The Labor Department’s case involved employer-sponsored plans, and the settlement coverage doesn’t say whether individual Marketplace members were included.

Pros and cons

Pros

• Strong 2026 quality ratings, with 9 of the nation’s 18 NCQA five-star plans.
• An integrated model that can mean more coordinated care between your insurance and your doctors.

Cons

• Sold in only 9 states plus D.C., so it’s not an option for most of the country.
• The HMO model means little to no coverage for care outside Kaiser’s own network except emergencies, so check this fits your situation first.
• A 2026 federal settlement over access to mental-health and substance-use-disorder care in California.

Other insurer guides: Ambetter, Blue Cross Blue Shield, Cigna, Molina, Oscar and UnitedHealthcare. See also the best health insurance companies.

See 2027 Kaiser Permanente plans and prices in your area: compare quotes by ZIP code.

Frequently asked questions

Does Kaiser Permanente sell plans in my state?

Only in California, Colorado, Georgia, Hawaii, Nevada, Oregon, Washington, Maryland, Virginia and Washington, D.C. If you live elsewhere, Kaiser isn’t a Marketplace option for you.

Is Kaiser Permanente an HMO?

Yes. Kaiser’s individual plans are HMO-style: you generally use Permanente Medical Group physicians and Kaiser-owned facilities rather than a broad outside network, so check that your preferred doctors are included before you enroll.

Are Kaiser Permanente plans highly rated?

In NCQA’s September 2026 ratings, Kaiser plans took 9 of the 18 five-star ratings awarded nationally, and 91% of its rated plans scored 4.5 stars or higher.

When does open enrollment end for Kaiser plans?

It depends on your state’s exchange, not on Kaiser. On HealthCare.gov, 2027 open enrollment runs through January 15, 2027, and some state-run exchanges, like California’s and D.C.’s, run through January 31. Confirm the exact date with your state’s exchange.

This article is general information, not insurance or legal advice. Plan availability, deadlines and pricing vary by region; confirm details with Kaiser or your state’s exchange before you enroll. Last reviewed September 2026.