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. 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. Some services are covered by Health Plan and KPIC, while other Kaiser Permanente Providers in Georgia are connected to your electronic health record, so they’re up-to-date on your care. 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. 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. Call 1-866-616-0047 (TTY 711) to speak with our Added Choice Contact Center. Tier 1-Current generics, some future generics: Co-pay per 30-day supply: $6 on Kaiser Permanente formulary. Find a provider online by using the Kaiser Permanente Provider Directory. A list of DeltaCare providers can be found at www.deltadentalwa.com. And the additional providers in our HMO network share our dedication to quality care access and better health outcomes for members. Get More Information in Your Benefits Booklet. 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. 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. Email Address. for more information about Emergency services. Contact Kaiser Permanente at any time through our. Access PPO and Elect PPO preauthorization (PDF) PPO: Options (no longer available for new sales) Kaiser Foundation Health Plan of Washington Options, Inc. When you combine the Options Federal Standard Option plan with Medicare coverage, your Kaiser Permanente coverage will make your Medicare coverage go further. With care and coverage working seamlessly together, Kaiser Permanente is uniquely designed to give you the information and support you need to live healthy. Dual Choice PPO plan allows access to In Network providers or any licensed provider. Show me. 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. 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. Kaiser Permanente Options Federal coverage can help pay for many expenses that are not covered by Medicare Parts A and B. For years, Katherine has been seeing her cardiologist, who is not an In-Network Provider. Dependent Life Insurance—The spouse or State Registered Same Sex Domestic Partner’s benefit is $1,000. You choose your own doctor and you can change your doctor at any time. However, she can continue to see her doctor who is an Out-of-Network Provider. You’re free to choose whatever provider you prefer, whenever you receive care. General information about Kaiser Permanente Washington's PPO plans. 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. Kaiser Permanente Dual Choice PPO is the best of all worlds. 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. To determine whether you are covered under the “Sound” or “SoundPlus” plan, look at the front of your Sound Health & Wellness Trust ID card. 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. Learning sessions will be held on Wednesdays beginning August 26, 2020, and ending November 18, 2020. Show me . Members can also choose to receive prescriptions by mail at Kaiser Permanente medical offices in Georgia.*. This amount will be paid to your beneficiary in the event of your death from any cause. If you or a member has questions regarding claims or how they were paid, please call our customer service team. 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). Claims are processed by our claims team in Denver, Colorado. 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. Your Kaiser Permanente Provider in Georgia will coordinate your care. 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. 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