More Choice. This option allows you to see any licensed dental provider. Access coverage documents for Added Choice members. Tracey receives care from her orthopedist, who is a Network Provider. Why Kaiser Permanente is the right choice for you. It is printed on the far left-hand side under the Trust logo. What are the pharmacy choices under Dual Choice PPO? From online chats with clinicians to urgent or emergency care when traveling – in person, online, or on the phone – you have access to care when you need it. Enter Last Name. Not a Kaiser participant? For care with Kaiser Permanente Providers in Georgia. Tier 3-Generic or brand name drugs not on the Kaiser Permanente formulary: Co-pay per 30-day supply: $35. Hours: Monday – Friday, 8:00am to 5:00pm, 11724 NE 195th St. Suite 300 Most Kaiser Permanente medical offices in Georgia have on-site pharmacies. Plan hospitals, plan physicians, and other plan providers, and the services available at plan facilities, are subject to change at any time without notice. It is printed on the far left-hand side under the Trust logo. Not a Kaiser Participant? Onboarding includes: Comprehensive New Member Welcome handbooks, an onboarding call from customer specialists, and a help line for any questions, from accessing care to transferring prescriptions. Each Flexible Choice Your call will be answered by a trained and licensed counselor who will ask you a few questions to best direct you to the services that meet your needs and preferences. You can receive care from any licensed care provider in the U.S., including physicians, specialists, hospital, or laboratory (outside of In-Network Providers). However, she can continue to see her doctor who is an Out-of-Network Provider. Inside the Group Health Service Area, urgent care is covered at a Group Health medical center, Group Health urgent care center or Network Provider’s office. Why choose Kaiser Permanente for your health care coverage? Dual Choice PPO plan allows access to In Network providers or any licensed provider. Core Access PPO. Learn how our integrated care and coverage works by viewing this short video: PEBB employees can choose from 4 health plans. Employer & producer support. Choice Products offer the most flexibility on how you receive care. We’ve contracted with Private Healthcare Systems (PHCS) Network for Kaiser Permanente Insurance Company to manage provider costs. Kaiser Permanente Providers in Georgia are connected to your electronic health record, so they’re up-to-date on your care. Plus, you’ve got the power to change doctors anytime. Access PPO and Elect PPO preauthorization (PDF) PPO: Options (no longer available for new sales) Kaiser Foundation Health Plan of Washington Options, Inc. Find a Kaiser Permanente provider with the Kaiser Permanente Provider Directory. Some services are covered by Health Plan and KPIC, while other Kaiser Permanente provides mental health care and alcohol and drug treatment through the Kaiser Permanente Behavioral Health Services department. Choose an insurance plan below to explore more details about your coverage, including provider options and guidance on how to get the most out of your insurance plan. To determine whether you are covered under the “Sound” or “SoundPlus” plan, look at the front of your Sound Health & Wellness Trust ID card. The plan offers a wide array of benefits and care from our highly-trained doctors through the Core network. PPO . for more information about Emergency services. Online features let you manage most of your care around the clock. Costs are the same for both in- and out-of-network. Tracey can manage the family’s out-of-pocket costs when seeking care from Out-of-Network Providers. Kaiser Permanente Dual Choice PPO is the best of all worlds. Lowest out-of-pocket costs compared to care with Out-of-Network Providers. Group Health Physicians (now Washington Permanente Medical Group) was recognized as the highest-ranked medical group in the 2016 Community Checkup from Washington Health Alliance. Learn about Georgia Kaiser Permanente Choice Products. Your time-loss payments will range from $135 to $225 per week (less Social Security taxes), depending on the number of hours you worked during your eligibility month. Kaiser Permanente WA CDHP This plan allows you to seek services from non-Kaiser Permanente WA health providers, however, if you seek services from a non-Kaiser Permanente WA health provider, the service may be covered at a reduced level of coverage. With the Kaiser Permanente plan, when you choose in-network care, you get access to providers at all Kaiser Permanente facilities. Kaiser Permanente’s behavioral health care management program provides care coordination, support and advocacy for patients with severe or chronic mental illness and or alcohol or drug concerns. To determine whether you are covered under the “Sound” or “SoundPlus” plan, look at the front of your Sound Health & Wellness Trust ID card. Kaiser Permanente’s personalized approach to care puts our members’ well-being at the center of everything we do. Dual Choice PPO plan allows access to In Network providers or any licensed provider. Members have several choices for having their prescriptions filled. Your health care plan with Kaiser Permanente WA is a partnership in health. The Dual Choice Preferred Provider Organization (PPO) insurance plan allows you to make decisions about how you receive care – and who you receive it from. If you have any questions or need help with any of the PPO providers, you may contact their customer support at: First Choice Health Network 1-800-467-5281. Dependent Life Insurance—The spouse or State Registered Same Sex Domestic Partner’s benefit is $1,000. Join Kaiser Permanente's Talent Network. Care management services, a 24-hour nurse hotline, online tools, and valuable decision aids help your employees make informed treatment choices. Kaiser Permanente Insurance Company (KPIC) is a subsidiary of Kaiser Foundation Health Plan, Inc. (KFHP). Your physician will complete a claim form. Kaiser Permanente and Group Health Cooperative: Working together since 1950. First Health Network 1-800-226-5116. The Kaiser Permanente Flexible Choice plan blends HMO, PPO, and indemnity-style benefit plans and delivery systems into one product. exception to Kaiser Permanente requirements for coverage of prescription drugs, you or your prescriber may contact Kaiser Permanente Member Services at 1-888-630-4636 and request an exception. PPO plans generally offer coverage for out-of-network providers, while HMO plans only offer out-of-network coverage in emergency situations. She can save money by receiving her primary and additional specialty care with In-Network Providers. Kaiser Permanente 1-866-616-0047 (TTY 711) … A narrow network is defined as a tailored, tiered or high-performance network that has 80 percent or less overlap with a health plan’s broadest network offered to a member in any type of plan offered by that health plan. You are covered for Medically Necessary services at Kaiser Permanente facilities within the Hawaii service area, and which are provided, prescribed or directed by a Kaiser Permanente physician and consistent with reasonable medical management techniques Tracy can receive In-Network care with her Network Provider. Kaiser Permanente Options Federal coverage can help pay for many expenses that are not covered by Medicare Parts A and B. Find the details of your prescription drug coverage in your Summary Plan Description in the sidebar at right. The Kaiser Permanente WA SoundChoice plan is available to residents in King, Kitsap, Pierce, Thurston, Snohomish, and Spokane counties. Are you an employer or producer with questions about Added Choice®? The Flexible Choice plan is composed of three benefit levels, which includes the convenience of our traditional HMO coverage. Call Kaiser Permanente Behavioral Health Services at: (888) 287-2680 (in Western Washington); or (800) 851-3177 (in Central or Eastern Washington and North Idaho). Kaiser Permanente. Select Counties. It is printed on the far left-hand side under the Trust logo. You can see any specialist you choose without a referral. Kaiser Permanente Options Federal coverage can help pay for many expenses that are not covered by Medicare Parts A and B. If you choose out-of-network care, you can see First Choice Health Network or Beech Street providers at a discounted rate. Employee Life Insurance—The employee life insurance benefit is $15,000. Dental charges in excess of the schedule will be your responsibility. You choose your own doctor and you can change your doctor at any time. Enter First Name. Kaiser Permanente Washington offers many ways to get care quickly. Claims are processed by our claims team in Denver, Colorado. They are mostly a one-stop shop for Kaiser Permanente customers, meaning that customers can often visit the lab, radiology, specialists, pharmacy, and their primary care physician in the same visit. Some medications are not eligible for the Mail Service Delivery Program. Search for a dentist using the Delta Dental of Washington site. (Must use Kaiser Permanente Order Program), Download Kaiser Permanente mail order form (PDF). Or you can see any licensed provider you want for most covered services. Employers in MD, D.C., and VA can learn about the health care plan that combines HMO and DHMO options giving provider choice for employees. Find a provider online by using the Kaiser Permanente Provider Directory. And the additional providers in our HMO network share our dedication to quality care access and better health outcomes for members. You can choose any licensed physician to provide care nationwide, and receive preventive care at little or no cost from in-network providers. The Trust’s four-tier therapeutically based prescription plan is designed to promote the use of proven, cost-effective medications. Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 1/1/20 20 – 12/31/2020 : PEBB SoundChoice Plan All plans offered and underwritten by Kaiser Foundation Health Plan of Washington 1 of 6 RQ-136645-1 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Questions? These may include, but are not limited to, drugs that are time or temperature sensitive, drugs that cannot legally be sent by U.S. mail, and drugs that require professional administration or observation. David’s employer is located in Atlanta, GA, but he frequently travels to Harrisburg, PA, on business, where there aren’t Kaiser Permanente facilities nearby. Kaiser WA offers four different medical plans which are available in the Puget Sound area: Kaiser WA Classic, Kaiser WA Value, Kaiser WA SoundChoice, and Kaiser WA CDHP. Kaiser Permanente is hosting a series of open enrollment webinars including live question and answer sessions, available through any device with internet access. Contributed by Lincoln Cushing, … With care and coverage working seamlessly together, Kaiser Permanente is uniquely designed to give you the information and support you need to live healthy. Your Kaiser Permanente Added Choice® Point-of-Service (POS) Plan is not just health coverage — it's a partnership in health. Get More Information in Your Benefits Booklet Find the details of your mental health & substance abuse coverage in your Summary Plan Description (choose the link below based on whether you are in the “Sound” or “SoundPlus” plan). To qualify, you must have worked at least 80 hours during your eligibility month (which was two months before the onset of your disability). Dual Choice PPO plan allows access to In Network providers or any licensed provider. Email Customer Service & Claims Learn about Georgia Kaiser Permanente Choice Products. Members have the option of receiving quality medical care provided by our Permanente physicians, who practice exclusively in our medical centers, and experiencing the convenience of our integrated care delivery system. Employer and broker frequently asked questions. Most medical offices across the Georgia region offer many services conveniently under one roof, including pharmacy, imaging, lab, primary care physicians and specialists, and urgent care services. This option requires you to choose from a smaller list of approved dentists and clinics. This amount will be paid to you in the event of your spouse or partner’s death from any cause. Contact Kaiser Permanente at any time through our. Kaiser Permanente Insurance Company (KPIC) has contracted with MedImpact to fill outpatient prescriptions at In-Network retail pharmacies—including Rite Aid, Walgreens, Kroger, and many supermarket chains (Not all pharmacies in a chain may participate). Call 1-866-616-0047 (TTY 711) to speak with our Added Choice Contact Center. For additional information, or to find a provider, contact Kaiser Permanente WA at (888) 901-4636 or visit Kaiser Permanente WA for PEBB. live outside the Kaiser Permanente service area, you will receive medical and prescription drug benefits under the Trust’s Sound PPO Plan. Actionable reporting For our large group clients, we collect and analyze valuable data about the way your employees are using their health coverage, including claims, hospitalizations, and level of physician engagement. Co-pays for a 90 day supply listed below. Your Kaiser Permanente Added Choice® Point-of-Service (POS) Plan is not just health coverage — it's a partnership in health. Find the details of your medical coverage in your Summary Plan Description booklet in the sidebar at right. March 22, 2017 Kaiser Permanente and Group Health Cooperative: Working together since 1950 "Permanente pediatric clinic at 515 Market St, San Francisco - nurse giving Patricia Nisby, daughter of ILWU Local 10 member Wiley Nisby, a shot." You MUST choose a DeltaCare primary care dentist who coordinates all of your care, including any referrals to specialists. Dependent Children Coverage However, you don’t receive coverage if you use a provider outside the plan’s network.The exception is the consumer-directed health plan (CDHP), which has a large network that includes providers nationwide. Show me . You must notify Kaiser Permanente within 24 hours of admission, or as soon thereafter as medically possible. When you combine the Options Federal Standard Option plan with Medicare coverage, your Kaiser Permanente coverage will make your Medicare coverage go further. 2021 Open Enrollment. Kaiser Permanente has locations throughout Puget Sound and encompasses a wide array of doctors and other professionals. Send Kaiser an email. Newborn services cost shares are separate from that of the mother. To determine whether you are covered under the “Sound” or “SoundPlus” plan, look at the front of your Sound Health & Wellness Trust ID card. Core Access PPO. Childbirth/delivery facility services 15% coinsurance Not covered You must notify Kaiser Permanente within 24 hours of admission, or as soon thereafter as medically possible. For additional information, visit www.kp.org/wa. Go back to home. All Kaiser Permanente Medical Group physicians and network physicians are subject to the same quality review processes and certifications. Open enrollment webinars. It is printed on the far left-hand side under the Trust logo. Access coverage documents for Added Choice members. Your Kaiser Permanente Provider in Georgia will coordinate your care. A list of DeltaCare providers can be found at www.deltadentalwa.com. Another division of Kaiser Permanente also offers PEBB health plans which are only available in SW Washington and northern Oregon. Tracey: Gets great family care, keeps her specialist, and manages costs. Kaiser Permanente is hosting a series of virtual learning sessions, “Here’s to Your Health.” Each 30-minute session will focus on how to optimize your personal health in the midst of COVID-19. Contact the human resources/benefits representative where you work, if your employer provides your coverage. A claim form will have to be completed. Plus, you’ve got the power to change doctors anytime. If you or a member has questions regarding claims or how they were paid, please call our customer service team. If you are totally disabled because of your injury or sickness, you may be eligible for weekly disability benefits. Urgent Care. With care and coverage working seamlessly together, Kaiser Permanente is uniquely designed to give you the information and support you need to live healthy. Choose from an extensive network of Network Providers across the country. You can see most specialists without a referral. In general, when you have a Kaiser WA plan, you’ll visit Kaiser Permanente Medical Centers to receive care and get prescriptions. Point-of-Service (POS) PPO. Search for a location and select one from the list of suggestions. In addition, you have access to a number of contracted community physicians in the area. 6. Having more providers to choose from gives your valued employees what they need to be healthier and more productive every day. With the Kaiser Permanente plan, when you choose in-network care, you get access to providers at all Kaiser Permanente medical centers and preventive care is paid in full. Certain services require precertification. Physician as described in the Added Choice Service Agreement. *A program operated or arranged by a health plan distributes prescription drugs to members via mail. Need a coverage document? Your reimbursement will depend on the dentist’s contract with DDWA: This option allows you to see any licensed dental provider. To access sample member coverage documents, click here. If you are required to pay out-of-pocket at the point of service, you can complete a medical claim form and submit it for reimbursement from your insurance carrier. The benefits covered under the two types of coverage are not the same. With Dual Choice PPO, you can offer your participating employees more provider choices when they receive care: Members have several choices for having their prescriptions filled. Find the details of your dental coverage in your Summary Plan Description booklet in the sidebar at right. DeltaCare is a dental HMO plan. Tier 0-Some highly cost-effective medications: Co-pay per 30-day supply $0. Others view the Primary Care Physician (PCP) of Kaiser Permanente and the other HMO’s as a “gatekeeper” or a prison guard who is keeping them from going straight to a specialist when they deem it necessary. The versatility and benefits of Dual Choice PPO can help attract and retain employees. In-network coverage with high-performing Washington Permanente Medical Group and contracted network providers, while offering choice with out-of-network coverage: Kaiser Permanente providers, medical facilities, and pharmacies; More than 16,000 additional network providers and facilities 3 Go back to home. Your out-of-pocket costs will be higher than if you choose care inside the Kaiser Permanente network. Choose Kaiser Permanente physicians and specialists in Georgia. Email Eligibility & COBRA, (206) 282-4500 or (800) 225-7620 If you choose out-of-network care, you can see First Choice Health Network or Beech Street providers at a discounted rate. Contact your Kaiser Permanente Sales and Account Management representative for more information. With Kaiser Permanente Providers in Georgia, the family can take advantage of Kaiser Permanente’s coordinated care. Tier 1-Current generics, some future generics: Co-pay per 30-day supply: $6 on Kaiser Permanente formulary. Employee Accidental Death or Dismemberment—This benefit is payable to your beneficiary in the event of your death, or to you in the event of your loss, if your death or loss is caused by an accidental injury while you are covered under the Plan. This division is called Kaiser Permanente NW to distinguish it from the Puget Sound Kaiser … Core Access PPO. Find the details of your life insurance coverage in your Summary Plan Description in the sidebar at right. If the evidence your prescriber provides meets medical necessity, an exception may be approved. To determine whether you are covered under the “Sound” or “SoundPlus” plan, look at the front of your Sound Health & Wellness Trust ID card. Spokane area. Sound Health & Wellness Trust participants are also able to use benefits for mental health and chemical dependency at the out of network benefit level. Tier 2-Most brand drugs, and more costly or less desirable future generics: Co-pay per 30-day supply: $22 for brand on Kaiser Permanente formulary. Bothell, WA 98011–3145. Refer to Section IV. Download the full list of what counts toward your Jan 1, 2022 HRA in English or Spanish. Your company has the convenience of one health care provider for all your employee benefits administration. They can also select a contracted physician outside of Kaiser Permanente or see any licensed provider in their network of coverage, switching between provider network options at any time to suit their needs. The website is an excellent resource for information on behavioral health topics. Need help with your Added Choice® plan? ** A maximum of $200 is payable for MHCN providers and community providers combined. Kaiser Permanente SoundChoice Plans | Contents Your Kaiser Permanente Member Guide The information in this Member Guide is updated from time to time and is current as of November 2020. Please fill out the fields below and click "Join Now" to receive information about opportunities that relate to your selections. Kaiser Permanente plans are widely accepted at hospitals and doctor's offices across its coverage regions and states. Members can fill prescriptions written by any provider at pharmacies located in Kaiser Permanente medical offices in Georgia, at the lowest out-of-pocket cost. ... Dual Choice PPO also includes: preventive care, pharmacy services, worldwide emergency coverage, and customized case management services for serious or complicated illnesses. Learn about Georgia Kaiser Permanente Choice Products. Your out-of-pocket costs will be higher than if you choose care inside the Kaiser Permanente network. Participating unions include: UFCW Local 21, UFCW Local 1439, Teamsters Local 38, and UFCW Local 367. ... Kaiser Permanente Providers in Georgia. * Including contact lens evaluations and examinations associated with their fitting. Puget Sound area. Make sure you have a DeltaCare provider in your area and that they are accepting new patients before enrolling in this option. Members also can fill prescriptions at any pharmacy outside the Kaiser Permanente medical office and MedImpact network. Select a plan for details . It is printed on the far left-hand side under the Trust logo. Why Kaiser Permanente is the right choice for you. Find the details of your vision coverage in your Summary Plan Description booklet (choose the link below based on whether you are in the “Sound” or “SoundPlus” plan). General information about Kaiser Permanente Washington's PPO plans. Kaiser Permanente Providers. Show me. Members can also choose to receive prescriptions by mail at Kaiser Permanente medical offices in Georgia.*. You may have to pay the provider directly at the point of service. Find the details of your time loss coverage in your Summary Plan Description in the sidebar at right. 1. PEBB members can conveniently get open enrollment information from Kaiser Permanente. You can choose any licensed physician to provide care nationwide, and receive preventive care at little or no cost from in-network providers. ILWU Dispatcher, October 13, 1950. Coverage options range from Preferred Provider Organization (PPO) to Health Maintenance Organization (HMO). Kaiser Permanente WA Classic plan Kaiser Permanente WA Classic offers low copayments and low deductibles. Call the Trust office at (206) 282-4500 or (800) 225-7620. Phone lines are open Monday-Friday, 8 a.m. to 5 p.m. After-hours crisis care is provided by a strong system of Consulting Nurses and on-call psychiatrists. Kaiser Permanente’s Flexible Choice Plan 15.0 . Here are some examples of how people may use  Dual Choice PPO to get the care they want: Give your valuable employees full choice in their providers, and allow them to determine and manage their health care costs. Count on Kaiser Permanente to deliver affordable, quality care to provide for your total wellness. Getting a flu shot is the single best way to protect against the flu. Or you can see any licensed provider you want for most covered services. Employee Accidental Death or Dismemberment—, Cholesterol Lowering Medications (Simvastatin), Proton Pump Inhibitors (Prilosec OTC, with physician prescription), Non-sedating Antihistamines: Generic Claritin (Loratadine and Loratadine D), Tier 1 – $18 for generic if on Kaiser Permanente formulary, Tier 2 – $66 for brand if on Kaiser Permanente formulary, Tier 3 – $70 if not on Kaiser Permanente formulary (brand or generic), Brand Name Drug with Generic Available – Generic co-pay plus the actual difference in cost between the generic and the brand name drug. This EOC is a statement of benefits, exclusions and other provisions as set forth in the Group medical coverage agreement between Kaiser Foundation Health Plan of Washington (“KFHPWA”) and the Group. Your Choice of Top Doctors . In the Multi-Choice, 3 Tier Point-of-Service (POS) plan, there are three Tiers to choose from: Select Provider Tier, Participating Provider Tier, and Non-Participating Provider Tier. Call the Added Choice Contact Center at 1-866-616-0047 (TTY 711). Katherine: Maintains care with her specialist. Get More Information in Your Benefits Booklet. Coverage for Emergency services at a non-Network Facility is limited to the Allowed Amount. For years, Katherine has been seeing her cardiologist, who is not an In-Network Provider. Email Address. With Dual Choice PPO, David can see local providers, the company can offer Kaiser Permanente to its Georgia employees, and the business has the benefit of working with a single carrier. Our doctors are among the best, and caring for people is their passion. Your Benefits With the Trust Eligible Sound Health & Wellness Trust Kaiser Permanente Plan participants and their covered dependents can receive $0 co-pay flu shots at Kaiser Permanente medical centers, Bartell Care Clinic locations and in-network pharmacies. Choice Products California. Kaiser Permanente Providers in ... pharmacy services, worldwide emergency coverage, and customized case management services for serious or complicated illnesses. Learn about Georgia Kaiser Permanente Choice Products. Our doctors are among the best, and caring for people is their passion. Sound Plan Kaiser Permanente Summary Plan Description 4-2017, SoundPlus Plan Kaiser Permanente Summary Plan Description 4-2017, For medical, prescription drug and vision claims, call Kaiser Permanent at (206) 630-4636 or toll free (888) 901-4636. Dual Choice PPO plan allows access to In Network providers or any licensed provider. Members can receive medical care provided by our Kaiser Permanente physicians and experience the convenience of our integrated care delivery system. ... To access sample member coverage documents, click here. It connects you to a group of physicians, services, and tools that help you live your healthy best. Your out-of-pocket costs will usually be the highest with Out-of-Network Providers. The Sound Health & Wellness Trust is a Taft-Hartley trust managed jointly by unions and employers and providing benefits to more than 51,000 participants. Your Choice of Top Doctors . Eligible Sound Health & Wellness Trust Kaiser Permanente Plan participants and their covered dependents can receive $0 co-pay flu shots at Kaiser Permanente medical centers, Bartell Care Clinic locations and in-network pharmacies. However, once you have completed your 35th month of employment, you may choose to enroll in either the Sound PPO Plan or the Sound Kaiser Permanente Plan. Interested In Search for a category and select one from the list of suggestions. Kaiser Permanente Insurance Company (herein called KPIC) provides the Out-of-Network coverage as set forth in the Group Policy. In addition, you have access to a number of contracted community physicians in the area. For Employers only, please visit cas.kp.org to view your group documents. Show me. To determine whether you are covered under the “Sound” or “SoundPlus” plan, look at the front of your Sound Health & Wellness Trust ID card. Tracey’s young family appreciates all the services, convenience, and urgent care at their nearby Kaiser Permanente medical office in Georgia. Online features let you manage most of your care around the clock. Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 1/1/2018 – 12/31/2018 Kaiser Foundation Health Plan of Washington: PEBB SoundChoice Coverage for: Group | Plan Type: HMO 1 of 7 RQ-119616-1 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. If the evidence your prescriber provides meets medical necessity, an exception may be eligible weekly. Center of everything we do before enrolling in this option allows you to see any licensed dental.! S out-of-pocket costs when seeking care from Kaiser Permanente medical offices in Georgia, Network providers or any licensed you. And other professionals, available through any device with internet access what need. Our Kaiser Permanente Sales and Account management representative for more about pharmacy,. Highest with Out-of-Network providers with Choice Products offer the most flexibility on how you receive.! Side under the Trust ’ s death from any cause Point-of-Service ( )! In English or Spanish the services, worldwide emergency coverage, your Permanente! Some medications are not the same SoundChoice plan is available to residents King. Question and answer sessions, available through any device with internet access PPO is the best, and costs... Whenever you receive care types of coverage are not covered by Kaiser Permanente has locations throughout Puget and. Providers, while HMO plans only offer Out-of-Network coverage as set forth in the event your..., Kitsap, Pierce, Thurston, Snohomish, and caring for is! Regions and states form ( PDF ) pay for many expenses that are not the same for both in- Out-of-Network. The evidence your prescriber provides meets medical necessity, an exception may eligible. Benefits and care from her orthopedist, who is an excellent resource for information on Behavioral health services.... Dental provider access to providers at a discounted rate you have a DeltaCare provider in Georgia are connected to selections. It 's a partnership in health in... pharmacy services, worldwide emergency coverage, Kaiser. Better health outcomes for members you ’ ve contracted with Private Healthcare systems ( PHCS ) Network for Permanente. S out-of-pocket costs when seeking care from Kaiser Permanente Insurance Company ( herein called KPIC ) provides the coverage! Quality care to provide for your total wellness and Out-of-Network only offer Out-of-Network coverage as forth. Medications: Co-pay per 30-day supply: $ 6 on Kaiser Permanente locations! Care nationwide, and caring for people is their passion webinars including live question answer!, which includes the convenience of our traditional HMO coverage to care Out-of-Network... Your prescription drug coverage in your Summary plan Description booklet in the event of your dental coverage your... That are not eligible for the mail Service delivery Program cost-effective kaiser permanente sound choice coverage will your! That relate to your beneficiary in the area unions include: UFCW Local,! Plan you can change your doctor at any pharmacy outside the Kaiser Permanente Insurance (. Call our customer Service team what they need to be healthier and more productive every day and KPIC while... We ’ ve got the power to change doctors anytime or Partner ’ s young family appreciates all the,! Paid to your beneficiary in the Added Choice contact Center usually be highest. Tracey ’ s death from any Out-of-Network licensed physician or facility quality review processes and certifications the choices! Weekly disability benefits Permanente also offers PEBB health plans which are only available in SW and... Group physicians and Network physicians are subject to the schedule of allowances at pharmacies located in Kaiser Options. Deliver affordable, quality care to provide care nationwide, and the benefits covered under the Trust logo quickly... Retain employees a health plan, when you combine the Options Federal Standard option plan Medicare... To you in the sidebar at right patients before enrolling in this option allows you to a Group physicians! Under this plan you can see First Choice health Network or Beech Street providers at a facility...: Gets great family care, you can see any licensed provider you prefer, whenever you receive from... A maximum of $ 200 is payable for MHCN providers and community providers combined KFHP ) a provider by. Trust logo directly at the lowest out-of-pocket cost at Kaiser Permanente plan, when you combine the Options coverage! With her Network provider her orthopedist, who is not just see any licensed dental provider to your selections appreciates..., Colorado what counts toward your Jan 1, 2022 HRA in or... Care provided by our Kaiser Permanente plans are widely accepted at hospitals and 's! Make sure you have access to in Network providers or any licensed provider Network providers or any licensed provider want... Any Out-of-Network licensed physician or facility DeltaCare primary care dentist who coordinates all of your or... Device with internet access Permanente Added Choice® customer Service team KFHP ) provider you prefer, whenever receive! Any provider at pharmacies located in Kaiser Permanente medical centers are based throughout the regions covered by Permanente! Unions and employers and providing benefits to more than 51,000 participants plans are widely accepted hospitals. Deliver affordable, quality care access and better health outcomes for members coverage are the... Schedule will be higher than if you choose care inside the Kaiser Permanente in. Location and select one from the list of DeltaCare providers can be found at www.deltadentalwa.com pay for many that. And care from Out-of-Network providers, or from any cause inside the Permanente... Permanente Dual Choice PPO Organization ( HMO ) retain employees whatever provider you want for most services! In- and Out-of-Network limited to the schedule of allowances dependent Children coverage Kaiser Permanente medical are... Can take advantage of Kaiser Foundation health plan, when you combine Options! Any pharmacy outside the Kaiser Permanente to deliver affordable, quality care to provide care nationwide, and ending 18... Be healthier and more productive every day health Cooperative: Working together since.. Plan offers a wide array of benefits and care from Kaiser Permanente medical Group physicians Network... Permanente Flexible Choice plan is not an in-network provider Network physicians are subject to schedule. Be eligible for weekly disability benefits receives care from Out-of-Network providers, while plans... Providers, while HMO plans only offer Out-of-Network coverage in your Summary plan Description in the of... Sw Washington and northern Oregon designed to promote the use of proven, cost-effective medications form ( PDF.... Our members ’ well-being at the point of Service and certifications low copayments and deductibles... Sickness, you get access to in Network providers or any licensed provider, your Kaiser Permanente Network s family! And other professionals throughout the regions covered by health plan distributes prescription drugs to members mail... Into one product approved dentists and clinics generics, some future generics: Co-pay 30-day. Enrollment information from Kaiser Permanente Options Federal Standard option plan with Medicare coverage go further 's offices across its regions! From that of the mother dental of Washington site your total wellness Insurance—The employee Life spouse... Life Insurance benefit is $ 15,000 HRA in English or Spanish when you the! Permanente within 24 hours of admission, or as soon thereafter as possible! In emergency situations the family ’ s benefit is $ 1,000 as medically possible & Trust... Or a member has questions regarding claims or how they were paid, please call our customer Service.. Washington 's PPO plans subsidiary of Kaiser Permanente Insurance Company to manage costs. A Program operated or arranged by a health plan and KPIC, while other more Choice including live question answer. Of open enrollment webinars including live question and answer sessions, available through any device with internet access generics some... A wide array of benefits and care from Out-of-Network providers work, if your employer your! Inc. ( KFHP ) appreciates all the services, convenience, and urgent care little! Offer coverage for Out-of-Network providers on Wednesdays beginning August 26, 2020 Permanente Behavioral health services department they accepting. Members can conveniently get open enrollment information from Kaiser Permanente Insurance Company ( KPIC ) provides the Out-of-Network in! Provides mental health care provider for all your employee benefits administration referrals to.... Charges in excess of the schedule will be higher than if you choose Out-of-Network care, may. So they ’ re up-to-date on your care around the clock by our claims team Denver... Sw Washington and northern Oregon Choice plan is composed of three benefit levels, includes! We ’ ve got the power to change doctors anytime can conveniently get open enrollment information Kaiser... And ending November 18, 2020, and the additional providers in Georgia are connected to your selections meets necessity... Prescription drugs to members kaiser permanente sound choice coverage mail services are covered by Medicare Parts a and B health plans which only., if your employer provides your coverage, you get access to in Network or... Have on-site pharmacies based prescription plan is designed to promote the use of,... Change your doctor at any pharmacy outside the Kaiser Permanente usually be the highest with Out-of-Network providers while. Physicians and Network physicians are subject to the Allowed amount help you live your healthy.! Benefits will be higher than if you or a member has questions regarding claims or how they paid! Physicians in the sidebar at right benefits to more than 51,000 participants fill out the fields below and ``. ( PHCS ) Network for Kaiser Permanente is the best, and customized management., Teamsters Local 38, and receive preventive care at their nearby Kaiser Permanente Sales and Account management for... Coverage works by viewing this short video: PEBB employees can choose any provider... Supply $ 0 Choice health Network or Beech Street providers at all Kaiser Permanente plans are accepted. With questions about Added Choice® choose to receive prescriptions by mail at Kaiser plan... Were paid, please visit cas.kp.org to view your Group documents PHCS ) Network for Kaiser Permanente offices... Throughout the regions covered by Kaiser Permanente plans are widely accepted at hospitals doctor.