Kaiser

Individual Application	$1500/30/Rx
$2000/30/Rx	$3000/30/Rx
$4000/30/Rx	$5000/30/Rx
HSA $2000/20/Rx	HSA $2500/20/Rx
Kaiser Locations	HSA $3000/20/Rx

Forms can be faxed to our office at (303) 721-1085. Please confirm that application was received by calling (303) 721-1145. Please call with any questions regarding eligibility or waiting periods.