Kaiser SFO HMO

Not sure what benefits you have? Visit our portal and select the “Enrollment” tab after you log in.

Contacts

Medical

Find a doctor

To find a doctor, call 800-464-4000 or visit www.kp.org.

Dental

• DeltaCare DHMO (over 19 years old)

  You can only go to your assigned dentist.

  • To find your assigned dentist:

    • Call 800-422-4234
    • Go to www.deltadentalins.com/deltacare

    • Download the Delta Dental mobile app:

      

  • To change your dentist:

    • Call 800-422-4234
    • Go to www.deltadentalins.com/deltacare

    Let DeltaCare know which in-network dentist you want to switch to by the 20th of each month. That way, you can start going there at the beginning of the next month.

  • Your benefits

    DeltaCare DHMO
    Your dentist	You can only go to your assigned dentist.
    Yearly deductible	No deductible.
    Yearly maximum	No maximum
    What you pay	You only pay your copay for each service. There are no copays for routine cleanings, exams, and x-rays.
    Who's covered?	Participants and their eligible dependents.
    Specialists	You must get a referral from your primary dentist to see specialists.
    Braces	Children and adults can get braces. You pay: $1,700 for children under the age of 19. $1,900 for adults age 19 and older. The Plan will only cover braces once for each person during their whole life.

• Kaiser Pediatric Dental (under 19 years old)

  Go to Delta Dental’s website at deltadentalins.com or call Delta Dental Customer Care at 800-589-4618.

Vision

• DeltaCare HMO (over 19 years old)

  You can choose any eye doctor in the VSP network. To find an eye doctor:

  • By phone

    • Call VSP at 800-877-7195

  • Online

    1. Go to www.vsp.com
    2. Click “Find a Doctor”
    3. Type in your zip code or address

  Your eye care costs

  Benefit	VSP Network	Non-network
  Eye exam	No copay	Plan pays up to $45. You pay the rest.
  Frames	$25 copay. Plan pays up to $175 for frames.	$25 copay. Plan pays up to $70. You pay the rest.
  Lenses		$25 copay. Plan pays up to $30 - $65, depending on lens type. You pay the rest.
  Contact lenses instead of glasses	Up to $50 for exam. Plan pays up to $175.	Plan pays up to $120. You pay the rest.

• Kaiser Pediatric Vision (under 19 years old)

  Visit kp2020.org.

Documents

• More care options while you're away from home
• Hospitality Plan Summary of Benefits and Coverage – Kaiser SFO (SBC)
  • 2024
  • 2025
• Hospitality Plan Summary Plan Description (SPD)
• Hospitality Plan Summary of Materials Modification (SMM)
• Hospitality Plan Kaiser Enrollment Booklet
• Hospitality Plan Summary Annual Report

Delta Dental

• Delta Dental Evidence of Coverage

  Get your dental HMO Evidence of Coverage files from Delta Dental:

  • Online
  • Call: 800-422-4234

Forms

• Life insurance beneficiary form