2020 Enrollment | Washington | Elect PPO Plans
Healthy together Care and coverage that fits your life
kp.org/wa Kaiser Permanente Care and coverage that fits your life
Welcome to care that fits your life Experience the Kaiser Permanente difference
Your doctor, your choice Choose your doctor based on what’s important to you. To be healthy, you need quality care that’s simple, personalized, and Go to kp.org/wa/directory for details about education, hassle-free. At Kaiser Permanente, we bring care and coverage together so specialties, and languages you get everything you need for your health in one easy-to-use package. spoken for doctors near you. You can also change doctors at any time. Support from More care options the get-go How you get care is Great care, great results 4 up to you. Besides Get help choosing in-person visits, you doctors and can chat online with a transitioning your Quality care with you at the center 5 clinician at kp.org/wa. care and prescriptions. Or call our 24/7 nurse Just call our dedicated helpline for advice New Member on symptoms and Your care, your way 6 Welcome Team. next steps.
Get more from your health plan 7
Finding network providers 8
Right care, right time Stay healthy Get the care you need for less Making it easier to switch plans 11 when you need it with Enjoy discounts routine, specialty, urgent, on fitness facilities and emergency care. and products or a Away from home? network of alternative Access in-network care providers. care from providers Or talk to a wellness nationwide. coach — at no cost.
Note: Kaiser Permanente Washington region does not include the Vancouver/Longview area. That area is part of Kaiser Permanente Northwest. 2 3 Kaiser Permanente Care and coverage that fits your life
Great care, great results Quality care with you at the center
From preventive screenings that help keep you healthy to world-class care Our physician-led care teams at Kaiser Permanente work together to help if you get sick, we’ve got you covered. keep you healthy by delivering high-quality, personalized care.
Preventive care to Support for Great care from Better care with help keep you healthy ongoing conditions great doctors a connected team
Preventive care is key to how we practice If you’re struggling with a condition like diabetes Doctors at Kaiser Permanente come from some Your doctor, nurses, and other specialists medicine at Kaiser Permanente. It can help or heart failure, you may be automatically of the top medical schools, and many of them all work together to help keep you healthy. you avoid some health issues and catch others enrolled in a disease management program for have practiced at leading hospitals across the At Kaiser Permanente facilities, they’re before they become serious. personal coaching and support, or you can ask country. No matter which personal doctor you connected to each other, and to you, through to be enrolled. With a well-rounded approach choose, you’ll be in highly skilled, experienced your electronic health record. So they know When you get care at a Kaiser Permanente backed by proven best practices, we’ll help you hands — and your health is their chief concern. important things about you and your health — facility, your electronic health record plays a get the care you need to continue living life to like when you’re due for a screening and what vital role — your preventive care services are the fullest. medications you’re taking. That way, you get tracked in the system, which triggers automatic Choosing a doctor — care that’s tailored for your individual needs. reminders when you’re due for your next your partner in health screening. We’ll let you know when to come in A leader in so you’re free to focus on living your life. clinical quality We make it easy to find the doctor who’s right Personalized care for for you — and you’re free to change doctors all patients In 2018, our commercial health plans led the at any time, for any reason. Having a good Specialty care state in more than 11 critical care measures, relationship is important because your personal Care at Kaiser Permanente isn’t one-size-fits- when you need it including breast and colon cancer screenings, doctor is your biggest health advocate, and all. We believe your story, background, and controlling high blood pressure, childhood you’ll work closely together to make decisions values are as important as your health history. Preventive care can help keep you healthy, but immunizations, 3 diabetes care measures, and about your health. To deliver care that’s sensitive to all cultures, we’re also here for you if you get sick or need timely prenatal care. Some of these rates were ethnicities, and lifestyles, we: specialty care. We have one of the largest Find details on doctors near you at among the highest in the country.1 multispecialty medical groups in the country, kp.org/wa/directory, including location, • Strive to hire doctors and staff who speak offering more than 50 specialties — from education, specialties, languages, and more than one language family medicine, obstetrics, and pediatrics to medical interests. • Offer telephone interpretation services in oncology, psychiatry, and neurosurgery. more than 150 languages In addition, your network gives you access to • Train our care teams on how to connect with other major medical groups and renowned and care for people of all backgrounds specialists and hospitals across the country.
1NCQA (National Committee for Quality Assurance) Quality Compass® 2018 HEDIS® Scores. Quality Compass® and HEDIS® (Healthcare Effectiveness Washington Permanente Medical Group has been one of the top-ranked medical Data and Information Set) are registered trademarks of NCQA. groups in Washington state for more than a decade.2 2Washington Health Alliance 2018 Community Checkup report, www.wacommunitycheckup.org. Ranking applies to Kaiser Permanente Washington’s medical group, Washington Permanente Medical Group, P.C. Ranking for previous years applies to then Group Health Cooperative’s medical group, formerly named Group Health Permanente, P.C. and now named Washington Permanente Medical Group, P.C.
4 5 Kaiser Permanente Care and coverage that fits your life
Your care, your way Get more from your health plan
Get care when and how you want it at Kaiser Permanente. With more options Good health goes beyond the doctor’s office. That’s why we offer so many to choose from, it’s easier to stay on top of your health. convenient resources to our members. Explore them all, and choose the ones that fit your life.
Choose how you connect to care Tools and resources for good health
Sign in to your secure kp.org/wa account and get real-time Reach your health goals with an action plan and one-on-one Wellness coaching medical care via Care Chat online messaging with a clinician, phone support. A trained coach will help you find personalized by phone Click 7 days a week, 24 hours a day. Email your doctor’s office anytime techniques that work for you. Also offered in Spanish. with nonurgent questions.3 Or get an online diagnosis for certain common conditions with our online visit feature. Get help to lose weight, eat healthier, deal with stress, and Healthy lifestyle more with our Skills for Life digital coaching tool for members. You may be able to save a trip to the doctor’s office by having programs Details at kp.org/wa/healthy-lifestyles. Call a phone appointment instead. We also offer a consulting nurse helpline for care guidance and advice by phone 24/7. Quit for good with one of the country’s most successful tobacco Help to quit cessation programs — at no additional cost. Phone-based or Drop in for quick care for minor needs at walk-in clinics at several smoking Come in of our medical facilities or at CareClinic at Bartell Drugs at 15 online. Visit quitnow.net/kpwa for more information. Puget Sound locations. No appointment needed. Our ChooseHealthy® program gives you access to a fitness center membership for just $25 a month, plus a $25 enrollment Most of our medical facilities have many services under one roof, Special rates fee. Or get 25% off participating provider standard fees for so you can see your doctor, get lab services or X-rays, and pick up for members Come in a prescription — all in the same trip. Or choose a doctor or facility acupuncture, chiropractic care, and therapeutic massage. from the extensive provider options in the Elect PPO network. See these and more discounts at kp.org/wa/member-perks.
Call the Resource Line at 1-800-992-2279 or email Manage your health your way Classes and [email protected] to find health classes and support support groups groups near you. You can also request patient education pamphlets and DVDs created for our medical facilities. Stay on top of your Kaiser Permanente care at kp.org/wa. Online Once you’re registered, you can view your medical record, refill 3 Visit kp.org/wa/health for wellness information, recipes, fitness most prescriptions, schedule routine appointments, and more. Wellness blog ideas, tips for healthy aging, and podcasts featuring members. Manage your care anytime, on the go. Access many of the features In app on kp.org/wa with the Kaiser Permanente Washington mobile app.4 Learn more at kp.org/wa/mobile.
3Some features only available when you receive care at Kaiser Permanente medical facilities. 4To use the Kaiser Permanente Washington app, you must be a Kaiser Permanente Washington member registered on kp.org/wa.
6 7 Kaiser Permanente Care and coverage that fits your life
Finding network providers
Our goal is to make it as easy and convenient as possible for you to get Washington state Pacific Northwest the care you need when you need it. With Elect PPO there are Kaiser kp.org/wa/directory First Choice Health network Permanente facilities or other network providers — locally, regionally, and fchn.com nationally — offering you a wide range of care and services.
Smokey Point Kaiser Permanente WA N medical facility locations Everett Bellevue (2) Port Orchard 5 Bothell Poulsbo Burien Puyallup Everett Redmond Lynnwood Federal Way Renton Choose from more than 10,000 Elect PPO With access to the First Choice Health network, Northshore providers5 at kp.org/wa/directory. In addition choose a provider in Alaska, Idaho, Montana, 5 Gig Harbor Seattle (5) Poulsbo Kent Silverdale to care from Kaiser Permanente physicians and Oregon, and, outside our service area, additional 405 Northgate Lynnwood Tacoma (2) specialists, you’ll recognize the names of many providers in Washington state. This network offers more than 100 hospitals, 500 medical Silverdale Ballard Redmond Olympia network affiliates. These are some examples. South Lake Union Capitol facilities, and 15,000 practitioners. Hill Bellevue Puget Sound: Swedish First Hill/Cherry Hill Downtown Seattle Hospitals, Overlake Medical Center, Providence Find all providers at www.fchn.com. Fill in the CareClinic by Rainier 90 hospitals, Seattle Children‘s Find a Provider fields for location, specialty, and Port Orchard Factoria Kaiser Permanente Burien Spokane: Providence hospitals and specialists, name (if you have one), then hit search. at Bartell Drugs Renton MultiCare Valley Hospital, Columbia Surgical A pop-up will ask you to select Entire First Alderwood Rainier Avenue Specialists Choice Health PPO Network, Employer/Group ID, or Employer/Group/Trust Name. Select Kent Ballard Redmond Olympic and Kitsap peninsulas: Mason Gig Harbor Bellevue Village Sammamish General Hospital, The Doctors Clinic, Peninsula “Entire First Choice Health Network.” Then view Federal Way Crossroads Silver Lake Community Health Services, and Harrison your results. HealthPartners Tacoma Des Moines Snoqualmie 5 Fairwood University Village Northwest Washington: Family Care Network, Steele Street* Gig Harbor West Seattle PeaceHealth specialists, Island Hospital, Puyallup Greenwood WhidbeyHealth Medical Center Olympia Southeast Washington: Kadlec Clinic, Lourdes Medical Center, Providence St. Mary West Olympia Medical Center, and Walla Walla Clinic
Kaiser Permanente WA medical facilities Kaiser Permanente WA medical facilities scheduled to open in 2019–2020 5Source: OIC Provider Network Form A CareClinic by Kaiser Permanente at Bartell Drugs
*Formerly named Tacoma South
8 9 Kaiser Permanente Care and coverage that fits your life
Making it easier to switch plans
All other states Changing health plans can seem like a lot of work, especially if you’re Local and national pharmacy access First Health in the middle of treatment or take prescription drugs. That’s why we myfirsthealth.com In network you’ll find hundreds of Washington created a dedicated New Member Welcome Team to help you transition pharmacies at kp.org/wa/directory or you to Kaiser Permanente. can always order refills through the Kaiser Permanente mail-order pharmacy. You also have Need help transitioning to a new plan? Call 1-888-844-4607. access at your out-of-network benefit level to the OptumRx national pharmacy network, which includes most well-known pharmacy chains. It’s easy to transfer your prescriptions so your treatment is uninterrupted. Either register online and create an account at Transfer your kp.org/wa to transfer your prescriptions yourself, or call our prescriptions Kaiser Permanente facilities New Member Welcome Team for help. You’ll be able to order in other regions refills online for convenient mail delivery to your home.
You can receive care or use pharmacies at any Kaiser Permanente facility in Southwest Our online doctor profiles let you browse among many excellent Washington, Oregon, California, Colorado, doctors and convenient locations in your area, so you can join Hawaii, Georgia, Maryland, Virginia, and the Find the Kaiser Permanente knowing you’ve found a doctor who fits your Outside the Pacific Northwest, you have access District of Columbia as a visiting member. right doctor needs. Plus, you can change your doctor at any time, for any reason. to an extensive network with 5,000 hospitals and View doctors at kp.org/wa/directory or call our New Member more than 1 million health care professionals. Check with Member Services if you’re looking Welcome Team for help. for care in other Kaiser Permanente regions. You can find these providers by going to Staff will help you find the closest place for myfirsthealth.com. Click “Start now,” select in-network care, and assist you in getting a You might want help transitioning your care to Kaiser Permanente if: the type of provider you’re looking for, decide visiting member ID number if needed. whether you want to search by ZIP code or • You have a scheduled surgery by state, and fill out the appropriate fields for • You’re taking a prescription drug or using medical equipment Transition location. Click “Search now” to view your results. • You’re pregnant and receiving prenatal care Your digital ID card your care • You’re following an established treatment plan Access your membership information anytime, Nonparticipating providers • A health provider is working with you to manage a anywhere, with the Kaiser Permanente digital medical condition membership card, an electronic version of your You can receive care from any licensed provider ID card. While traveling, the digital card lets in the U.S. at your out-of-network benefit level. you provide your membership and network This choice has the highest out-of-pocket costs. information right from your phone. You’ll find Because these providers aren’t contracted with the link to your digital card on your secure home We’re focused on helping new members Kaiser Permanente, you will need to pay for page once you’ve registered for online services services when received, and then submit claims and signed on. Our dedicated team can help you select a doctor, transfer prescriptions and medical records, for reimbursement. and connect with resources to meet your unique needs. Other questions about transitioning care? Give us a call at 1-888-844-4607.
10 11 Kaiser Permanente
Kaiser Permanente Nondiscrimination AN A E A E E V E Notice and Language Access Services E : ATTENT ON: s ea a an a e t er t an n is an a e assistan e ser i es ree ar e are a ai a e t a ( r )
E : ATEN N: i a a es a tiene a s is si i n ser i i s rat it s e asisten ia in sti a KAISER PERMANENTE NONDISCRIMINATION NOTICE ame a ( ) 中文 ：注意：如果您使用繁體中文，您可 以免費獲得語言援助服務。請致電 Kaiser Foundation Health Plan of Washington and Kaiser Foundation Health Plan of Washington Options, Inc. ( )。 (“Kaiser Permanente”) comply with applicable federal civil rights laws and does not discriminate, exclude people, or treat them differently on the basis of race, color, national origin, age, disability, sex, sexual T ế V ệ V : : ế ạn n i iến iệt ị ụ ỗ trợ n n n ữ miễn n orientation, gender identity, or any other basis protected by applicable federal, state, or local law. We also: ạn ọi số ( ) Provide free aids and services to people with disabilities to help ensure effective communication, such as: 한국어(Korean): 주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. ( ) 번으로 전화해 주십시오. • Qualified sign language interpreters • Written information in other formats (large print, audio, and accessible electronic formats) Русский : ВНИМАНИЕ: Если вы говорите на русском языке то вам доступны бесплатные услуги • Assistive devices (magnifiers, Pocket Talkers, and other aids) перевода Звоните (телетайп ) Provide free language services to people whose primary language is not English, such as: T : A NA A: K n na sasa ita a n a a maaari an mamit n m a ser is n t n sa i a nan a an a a ma a sa ( ) • Qualified interpreters • Information written in other languages Українська : УВАГА Якщо ви розмовляєте українською мовою ви можете звернутися до безкоштовної служби мовної підтримки Телефонуйте за номером If you need these services, contact Kaiser Permanente. (телетайп )
If you believe that Kaiser Permanente has failed to provide these services or discriminated in another way on 徶羶ߒមែរ ៖ របយ័ត៖ េ េបើសិនអកនិߒយមរ, េ សជំនួߒយផក េ យមិនគិតល គឺចនសំប់បំេ រអក។ ចូរទូ រស័ព the basis of race, color, national origin, age, disability, sex, sexual orientation, or gender identity, you can file a grievance. Please call us if you need help submitting a grievance. The Civil Rights Coordinator will be notified ( )។ of all grievances related to discrimination. 日本語 J : 注意事項：日本語を話される場 合、無料の言語支援をご利用いただけます。 ( ) まで、 お電話にてご連絡ください。 Kaiser Permanente አማርኛ A ፥ ማስታወሻ: የሚናገሩት ቋንቋ ኣማርኛ ከሆነ የትርጉም እርዳታ ድርጅቶች፣ በነጻ ሊያግዝዎት ተዘጋጀተዋል፡ ወደ Phone: 206-630-4636 ሚከተለው ቁጥር ይደውሉ (መስማት ለተሳናቸው ) Toll-free: 1-888-901-4636 O O : EE ANNAA: aan att r mi a ta aa i a ar aarsa a aanii an a tii aan a a ni TTY Washington Relay Service: 1-800-833-6388 or 711 ar ama i i aa ( ) TTY Idaho Relay Service: 1-800-377-3529 or 711 ਚ ਸਹਾਇਤਾ ਸੇ ਾ ਤੁਹਾਡੇ ਲਈ ਮੁਫਤ ਉਪਲਬਿ ਹੈ। ﹱ Electronically: kp.org/wa/feedback ਪੰ ਜ ਾ ਬ ੀ ਧਿਆਨ ਧਿਓ ਜੇ ਤੁਸȂ ਪੰ ਜ ਾ ਬ ੀ ਬੋਲਿੇ ਹੋ ਤ拓 ਭਾਸਾ ਧ ( 6388 / 711) ‘ਤੇ ਕਾਲ ਕਰੋ। العربية :A لديكم حق الحصول على مساعدة ومعلومات في ملحوظة :إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغوية تتوافر You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil لك بالمجان اتصل برقم رقم هاتف الصم والبكم ( ) Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: : A T N : enn ie e ts s re en ste en nen sten s s ra i e U.S. Department of Health and Human Services i s ienst eist n en r er n n mmer ( ) 200 Independence Avenue SW., Room 509F ພາສາລາວ : ໂປດຊາບ ຖ້ າວ່ າ ທ່ ານເ ວ້ າພາສາລາວ ການໍບ ິລການຊ່ ວຍເຫ ອດ້ ານພາສາ ໂດຍໍ່ບເສັ ຽຄ່ າ HHH Building ແມ່ ນີມພ້ ອມ ໃຫ້ ທ່ ານ ໂທຣ ( ) Washington, DC 20201 : OBAVJEŠTENJE: rite sr s hrvatski, usluge jezičke pomoći dostupne 1-800-368-1019, 800-537-7697 (TDD) s am es atn a ite ( Telefon za osobe sa oštećenim govorom ili sluhom: Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html )
For Medicare Advantage Plans Only: Kaiser Permanente is an HMO plan with a Medicare contract. Enrollment in : ATTENT ON: Si vous parlez français, des services d’aide linguistique vous sont proposés Kaiser Permanente depends on contract renewal. rat itement e e e ( ) Română (Romanian): ATENȚIE: Dacă vorbiți limba română, vă stau la dispoziție servicii de asistență lingvistică, gratuit. Sunați la 1 ( ) A : AAN O: a aa i ama a e i a i ma t e itaa i e aa ( )
فارسی : توجه :اگر به زبان فارسی گفتگو می کنيد، تسهيالت زبانی بصورت رايگان برای شما فراهم می Kaiser Foundation Health Plan of Washington H5050_XB0001444_56_18 accepted 2018 © باشد با ( ) تماس بگيريد 2018-XB-7_ACA_Notice_Taglines
12 13 Want to learn more?
Visit kp.org/wa or call Member Services Monday through Friday, 8 a.m. to 5 p.m.
• 1-888-901-4636 (English and more than 150 languages with our interpreter services) • 711 (TTY)
Our New Member Welcome Team will also assist prospective members: 1-888-844-4607
Already a member? Manage your care online anytime at kp.org/wa. If you haven’t already, go to kp.org/wa/register so you can start ordering most prescription refills, get reminders about needed care, and view coverage documents. If you get care at Kaiser Permanente, you can start emailing your doctor’s office with nonurgent questions, scheduling routine appointments, and more.
15 The right choice for a healthier you Having a good health plan is important. So is getting quality care. With Kaiser Permanente, you get both.
Kaiser Foundation Health Plan of Washington Options, Inc. 601 Union St., Ste. 3100 Seattle, WA 98101
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©2019 Kaiser Foundation Health Plan of Washington XB0001588-53-19