Questions? 2 Kaiser Permanente Access PPO 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. Members are entitled to Covered Services from the following: • Your Provider Network is KFHPWAO’s Summit PPO Network, referred to … See doctors in your network, choose a doctor, and use the cost estimator. This card lists the member's name, ID number, and health plan network. Broad physician choice, including: Kaiser Permanente providers at our medical facilities, where you can get many services under one roof; First Choice Health and First Choice networks, located in the State of Washington or throughout the United States, which allows you to keep your doctor in most cases <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 17 0 R 18 0 R 19 0 R 20 0 R 21 0 R 22 0 R 23 0 R 24 0 R 25 0 R 26 0 R 27 0 R 28 0 R 29 0 R 30 0 R 31 0 R 37 0 R 38 0 R 39 0 R 40 0 R 41 0 R 42 0 R 43 0 R 44 0 R 45 0 R 46 0 R 47 0 R 48 0 R] /MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> While HMO and PPO plans are the 2 most common plans, especially when it comes to employer-provided health insurance, there are other plan types you should know about, including EPO and POS plans. 3 0 obj Coverage for: Individual / Family | Plan Type: PPO Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 1/1/2020 – 12/31/2020 : School Employees (SEBB) Access PPO 1 All plans offered and underwritten by Kaiser Foundation Health Plan of Washington Options, Inc. 1 of 7 QR-83109-1 For information on how to select a personal physician, and for a list of the participating personal physicians, please call Kaiser Permanente Member Services at (206) -4636 in the Seattle area, or toll630 -free in Washington, 1-888-901-4636. You must notify Kaiser Permanente within 24 hours if admitted to an Out-of-network provider; limited to initial emergency only. Kaiser Foundation Health Plan of Washington Options, Inc. First Health Network 1-800-226-5116. We will continue to provide excellent care to our members through a broad array of virtual care options and in person when necessary. Other types of health plans. Kaiser Permanente provides coverage to employer groups, government programs, individuals, and families through the Kaiser Foundation Health Plan of Washington and Kaiser Foundation Health Plan of Washington Options, Inc. Drug formulary Kaiser Permanente's drug formulary is a list of medications covered by your health plan. 2 0 obj Coverage for: Individual / Family | Plan Type: PPO Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 1/1/2020 – 12/31/2020 : School Employees (SEBB) Access PPO 2 All plans offered and underwritten by Kaiser Foundation Health Plan of Washington Options, Inc. 1 of 7 QR-83108-1 Kaiser Permanente. Kaiser Permanente Washington Options Federal. 1143 0 obj <> endobj <> You can choose Core HMO plans with in-network coverage featuring high-quality health care providers or Access PPO plans with broad physician choice from any licensed provider and care when needed. Kaiser Permanente WA Options members can choose from thousands of network providers throughout our service area and nationwide. If you have any questions or need help with any of the PPO providers, you can also call them: First Choice Health Network 1-800-467-5281. Coverage for: Individual / Family | Plan Type: PPO Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 1/1/2020 – 12/31/2020 : School Employees (SEBB) Access PPO 3 All plans offered and underwritten by Kaiser Foundation Health Plan of Washington Options, Inc. 1 of 7 QR-83107-1 1. �����N9�*�?��rA�Kx���Ю�V';i���U�:ᝪ���`�h`��`��`� 29::�����(�1 Choose from 2 new Virtual Plus, 9 Core HMO, 9 Access PPO, and 3 Elect PPO plans. KFHPWAO’s Access PPO network and who is available to accept the Member or the Member’s family members. Developed in collaboration with Delta Dental of Washington, our Health360 plan offers integrated dental benefits for whole body health. Think higher cost with greater flexibility. %���� You can compare benefit information, networks, and monthly premiums. endobj An extremely limited number of COVID-19 vaccine doses have started arriving at Kaiser Permanente facilities, and we are currently administering… Read More Dec 15, 2020 The Kaiser Foundation Health Plan of Washington Options, Inc. Federal PPO provides access to an expansive network of local, statewide, and nationwide participating providers. 1162 0 obj <>/Filter/FlateDecode/ID[<722FD9695C654D4CAAACE4285D728A0B><0F142A3723E9374D9975B422388118B0>]/Index[1143 48]/Info 1142 0 R/Length 94/Prev 215873/Root 1144 0 R/Size 1191/Type/XRef/W[1 2 1]>>stream stream Use the Kaiser Permanente Washington Plan Comparison Tool to find the plans available to you in your area. Compare Your Options Plan Brochure. For information on how to select a personal physician, and for a list of the participating personal physicians, please call Kaiser Permanente Member Services at (206) 630-4636 in the Seattle area, or toll-free in Washington, 1-888-901-4636. %%EOF For information on how to select a personal physician, and for a list of the participating personal physicians, please call Kaiser Permanente Member Services at (206) 630-4636 in the Seattle area, or toll-free in Washington, 1-888-901-4636. Small group benefit changes include: Summaries of Benefits and Coverage - English ... 2021 Access PPO VisitsPlus Silver LX EO 2021 Access PPO VisitsPlus Gold LX Your search results will reflect these temporary changes. The Elect PPO 2 plans provide the choice and flexibility of getting in-network care from the high-performing Kaiser Permanente provider network within our Washington service area and from the broad provider networks of First Choice Health and First Health outside of our Washington service area.. Kaiser Permanente providers, medical facilities, and pharmacies <>/Metadata 1450 0 R/ViewerPreferences 1451 0 R>> KFHPWAO’s Access PPO network and who is available to accept the Member or the Member’s family members. Staying healthy is easier with the right support. The Options PPO plan offers you two levels of coverage: preferred providers and nonpreferred providers. h�b```��,�@(� Access PPO and Options Federal include prescription coverage at all Kaiser Permanente Washington pharmacies and mail order, contracted pharmacies, and the OptumRx national pharmacy network. No referrals are needed for most specialty care. h�bbd``b`� ��� �~H0j�X��tK���@D%��$XA�T�W4�p�{d� �T�����2��q`����� qUh In-network care is provided by Kaiser Permanente providers and more than 16,000 contracted providers 1 within our 18-county service area and by First Choice Health network providers in Washington counties not in our service area. A PPO plan is also generally more expensive than an HMO plan. Preventive care to Permanente or non–Kaiser Permanente hospital Product and plan updates. Copayment waived if admitted directly to the hospital as an inpatient. Please call Member Services to speak with a representative Monday through Friday, 8 a.m. to 8 p.m.. 1-888-901-4636 (TTY 711) L'��620���a�g� y�mC���eL�[�x�D�hf�2:|�c�bX�y��ہ���@�����%Hs30�s2��ź�H10�?Ҍ@!s� �;. Emergency medical ... Kaiser Permanente WA Options Access PPO 2 … KFHPWAO’s Access PPO network and who is available to accept the Member or the Member’s family members. Kaiser Permanente 1-866-616-0047 (TTY 711) First Health Network 1-800-226-5116. Kaiser Permanente WA Access PPO 2 The Access PPO 2 plan has a lower monthly employee contribution than Access PPO 3, but with a higher out-of-pocket maximum and a higher annual deductible for medical services. Enhanced benefit: Access PPO is the only PPO network that gives you in-network access to the quality doctors at Kaiser Permanente medical offices. How Covered Services Work A. Accessing Care. Care from a First Choice Health network provider within our 18-county service area is covered at the out-of-network benefit level. Our 2021 small group portfolio offers 23 plan options. We issue ID cards to all members. Exclusive high performing network that includes Washington Permanente Medical Group with select medical groups and providers to provide coverage in 6 core counties at the Tier 1 level, Tier 2 are the remaining providers in the Access PPO … Our Access PPO plans include all of the features and services that are part of our award-winning HMO plans. Documents listed here are current as of December 8th, 2020. %PDF-1.7 1190 0 obj <>stream 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. 1 0 obj Kaiser Permanente Medicare Advantage members should call Medicare Member Services at 1-888-901-4600 (TTY 711), 7 days a week, 8 a.m. to 8 p.m. Kaiser Permanente urgent care. Contact Kaiser Permanente Member Services at 206-630-4636 or toll-free 1-888-901-4636 for benefits questions. And we include incentives, such as lower cost shares, to encourage your employees to engage with Kaiser Permanente physicians and receive nationally recognized care. Kaiser Permanente 1-866-616-0047 (TTY 711) For information on how to select a personal physician, and for a list of the participating personal physicians, please call Kaiser Permanente Member Services at (206) -4636 in the Seattle area, or toll630 -free in Washington, 1-888-901-4636. endobj endstream endobj 1144 0 obj <. 0 When members need in-person care away from home, they should first call Member Services at 1-888-901-4636 (TTY 711) to find the closest in-network option. Search for doctors, medical centers, pharmacies, and walk-in clinics. (Members receive care in all states EXCEPT OR, WA, ID, MT, WY, ND, SD, and AK.) … <> Kaiser Permanente Washington offers health insurance and medical care in Washington state. Plan hospitals, plan physicians, and other plan providers, and the services available at plan facilities, are subject to change at any time without notice. endobj To meet patient needs related to COVID-19, some Kaiser Permanente locations and providers are temporarily not available for in-person care. (Members receiving care in all states EXCEPT OR, WA, ID, MT, WY, ND, SD, and AK.) x��}[o9����|X,���N2y�l4z���{�3ӽm`0h�\*I��T���u�A2odd�2)m-�������1"����asq�:d?������lu�>��x�~{8lo����ǻ��_�.7�g�������_���a������>d�|����cU��"�5���n�����-�}����ׯ�}d����ׯ�iTd,E.D�E�E���4��w�]���e��[�~����?N����>���W6_���WG��!���\V�"gRg�Ӱ0�D��������_O��ӷ���>&�Ks�Wj6],%����n. By combining a Kaiser Permanente health plan with a Delta Dental PPO plan, members enjoy access to high-quality Kaiser Permanente medical care and the nation’s largest contracted network of dentists in a single package. The plans offered by Kaiser Foundation Health Plan of Washington or Kaiser Foundation Health Plan of Washington Options, Inc., give you choices. Members also get exclusive access to Kaiser Permanente WA‘s Washington Permanente Medical Group. Primary care office visits are covered at $25, or $15 when services are received at a Kaiser Permanente Washington medical facility. 4 0 obj Quick links. Kaiser Permanente. Find out Kaiser Permanente's list of medications covered by Individual and Family, Medicare Advantage, Small Employer Group, Large Employer Group, and FEHB plans. When you choose these doctors—and other select high-performing Washington providers in the major areas we serve—you'll enjoy the reduced cost shares seen in the "In network enhanced" column. %PDF-1.5 %���� 2021 Kaiser Permanente Small Group Plan Documents Compare Plan Options. 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