Information about Kaiser Permanente in Hawaii: Kaiser Permanente's Hawaii Website Who Provides Care: All care provided by Kaiser doctors and hospitals. Medical Necessity: Services covered only if Plan determines medical necessity exists. Reimbursement Procedures: No claim forms or deductible; you pay copayment, if any, at time of visit. Hospital Services Room and Board No charge Surgery and Anesthesia No charge Maternity No charge Emergency Room $5 copayment Outpatient Services Office Visits $5 copayment per visit Well-Woman Exam; Pap Smear; Mammograms $5 copayment per visit Prenatal Care No charge Prostate Exam $5 copayment per visit Well-Child Exams; Inoculations $5 copayment per visit Prescription Drugs $5 copayment/up to 30-day supply Chiropractic Care Not covered Ambulance No charge Mental Health/ Substance Abuse Mental Health - Inpatient 20% copayment; 30-day maximum per year Mental Health - Outpatient 20% copayment per visit: 20 visit maximum per year Substance Abuse - Inpatient 20% copayment; 30-day maximum per year Substance Abuse - Outpatient 20% copayment per visit: 20 visit maximum per year