Treatment FAQ

where to go for emergency treatment with kaiser permaente advantage plan

by Jaclyn Walsh Published 3 years ago Updated 2 years ago
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Visit a Kaiser Permanente urgent care clinic location. Find urgent care locations by visiting kp.org/locations or calling the Away from Home Travel Line at 951-268-3900 (TTY 711).

Can you go to Kaiser ER with Medi Cal?

At Kaiser Permanente, you have a wide network of doctors and specialists to choose from. All of our available doctors accept Kaiser Permanente members with Medi-Cal coverage.

Can I use my Kaiser insurance anywhere in California?

Kaiser Permanente service areas include all or parts of: • California • Colorado • Georgia • Hawaii • Maryland • Oregon • Virginia • Washington • Washington, D.C. As a Kaiser Permanente member, you're covered for emergency and urgent care anywhere in the world.

Can I use Kaiser Northern California in Southern California?

If you're enrolled in one of these plans in either the Northern California or Southern California region, you may receive visiting member services in the other California region. When you visit any Kaiser Permanente region, your coverage is the same as it is in your home region. The 90-day limit does not apply.

Does Kaiser Cover Calaveras County?

The plans below are the Kaiser Permanente plans that will be available in Calaveras County for the 2017-2018 plan year.
...
Kaiser Permanete of California.
Plan NameBenefit SummaryWhere to Buy
Kaiser Gold 80 HMO CoinsuranceBenefit SummaryWhere to Buy
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What cities in California have Kaiser Permanente?

Service areas
  • Service areas.
  • Napa-Solano Greater San Francisco Marin-Sonoma Diablo Greater Sacramento Redwood City Central Valley East Bay Fresno Greater Southern Alameda County South Bay.
  • Grants.
  • Community programs.
  • Medical Financial Assistance Program.
  • Programa de Asistencia Financiera para Gastos Médicos.

What states have Kaiser Permanente locations?

Kaiser Permanente provides care in many states across the country, including all or parts of:
  • California.
  • Colorado.
  • Georgia.
  • Hawaii.
  • Maryland.
  • Oregon.
  • Virginia.
  • Washington.

Will Kaiser Permanente expand to Arizona?

The facility will have an internal medicine hospital, ED, and digital imaging suite, and it's currently slated to open in the fall of 2021. Exceptional Healthcare also is planning to build hospitals in Prescott, Yuma, and other cities in Arizona (Paavola, Becker's Hospital Review, 11/5).Nov 11, 2020

Is Kaiser in all 50 states?

As of 2017, Kaiser Permanente operates in eight states (Hawaii, Washington, Oregon, California, Colorado, Maryland, Virginia, Georgia) and the District of Columbia, and is the largest managed care organization in the United States.

Can I keep Kaiser if I move to Nevada?

A good example is Kaiser in California. If you have this health insurance when moving to Nevada, you will not have any doctors that are covered in the state. Although moving to a new state is considered a qualifying life event.Dec 26, 2021

Is Kaiser expanding to Monterey County?

Those doctors say Kaiser plans to bring 15 primary care physicians to Monterey County, and is looking to contract for specialists; without local specialists participating, referrals will likely go to Kaiser's already-established Bay Area facilities.Nov 12, 2021

Is there a Kaiser hospital in Reno?

As of today, Kaiser Permanente does not offer health plans to Nevada residents. Even though it is unlikely, at some point in the future we may see Kaiser in Nevada.Jun 15, 2021

What cities in Washington state have Kaiser?

Locations
  • St. Michael Medical Center.
  • St. Joseph Medical Center.
  • Providence Regional Medical Center.
  • Providence Sacred Heart Medical Center & Children's Hospital.
  • Providence St. Peter Hospital.

Does Kaiser Permanente cover urgent care?

Kaiser Permanente may cover medically necessary urgent care you get when you’re temporarily outside the country — if it can’t be delayed until you get back home. Please refer to your . Evidence of Coverage. or other coverage documents for any restrictions. For specific timing considerations, please refer to your .

How to contact Kaiser Permanente for reimbursement?

For help with filing a claim for reimbursement, call the Away from Home Travel Line at . 951-268-3900. 1. If a member receives emergency services in a country where the U.S. government has imposed sanctions, the member may have to pay for services and then submit a claim to Kaiser Permanente for reimbursement.

Does Kaiser cover transportation?

Kaiser Permanente Georgia health plan does not cover transportation services for nonurgent, nonemergency care from outside the service area; and any request for transportation is subject to review. 3 . Kaiser Permanente providers, go to the . kp.org/travel .

Does Kaiser Permanente discriminate?

Kaiser Permanente Insurance Company (KPIC) complies with applicable federal civil rights law and does not discrimina te on the basis of race, color, national origin, age, disability, or sex. KPIC does not exclude people or treat them differently because of race, color, national origin, age, disability or sex. We also: .

Where is the Civil Rights Coordinator at Kaiser?

You may also contact the Kaiser Permanente Civil Rights Coordinator directly at One Kaiser Plaza, 12th Floor, Suite 1223, Oakland, CA 94612.

Where to file a grievance with KPIC?

If you believe that KPIC has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance by mail or phone at: KPIC Civil Rights Coordinator, 3701 Boardman-Canfield Rd, Canfield OH 44406, telephone number 1-866-213-3062.

Does Kaiser offer PDP?

Besides Medicare Advantage plans, Kaiser also offer Medicare prescription drug plans (PDPs). Most Kaiser Medicare Advantage plans include prescription drug coverage, but Kaiser also provide a separate, stand-alone PDP. The PDP uses a formulary that advises on the cost of medication.

What are the extra benefits of Kaiser?

Extra benefits may include preventive, vision, and dental care . The Kaiser Permanente organization are a nonprofit healthcare plan provider with a hospital network, an insurance system, and a network of salaried healthcare providers.

Is Kaiser Permanente a nonprofit?

Kaiser Permanente is a nonprofit organization that offer healthcare plans, including Medicare Advantage. They also have a network of hospitals and healthcare providers. A person eligible for Medicare can receive their Part A and Part B benefits through original Medicare or through a Medicare Advantage plan.

Is Kaiser a nonprofit?

The Kaiser Permanente organization are a nonprofit healthcare plan provider with a hospital network, an insurance system, and a network of salaried healthcare providers . In 2020, the Centers for Medicare and Medicaid Services awarded Kaiser their highest rating of 5.0 out of 5.0 stars for their Medicare health plans in their annual Star Ratings.

What is a PPO plan?

Preferred Provider Organization (PPO) plans. Kaiser Medicare Preferred Provider Organization (PPO) plans offer more freedom. Individuals are not required to use in-network healthcare providers and can visit any provider without a referral. Specific procedures, such as surgery or radiology, may require preapproval.

Do you need preapproval for a PPO?

Specific procedures, such as surgery or radiology, may require preapproval. If a person uses an in-network provider, the cost is generally lower. Some PPO plans offer the member the choice of selecting a PCP, which will also save on costs.

Does Kaiser offer supplemental insurance?

Optional benefits. Kaiser offer individuals a supplemental plan called Advantage Plus that can be added to a Medicare Advantage plan. Advantage Plus is not available on its own. The Advantage Plus plan provides dental coverage and vision and hearing benefits beyond those included with the Medicare Advantage plan.

Available Medicare Advantage plans

Kaiser Permanente offers HMO Medicare Advantage plans. Many plans offer dental, vision and hearing benefits, and worldwide emergency care. Kaiser doesn't offer any stand-alone Medicare prescription drug plans.

Additional benefits

Kaiser Permanente Medicare Advantage offers many members access to routine vision, dental and hearing coverage. Some plans offer other benefits as well. Here are a few standouts, although their availability varies by plan:

Customer service

Kaiser Permanente Medicare Advantage members can contact their plan’s customer service in a few ways:

Kaiser Permanente Medicare Advantage service area

Kaiser Permanente offers Medicare Advantage plans in eight states and Washington, D.C., including 115 counties [2].

Cost

Costs for Medicare Advantage plans will depend on your plan, your geographic location and your health needs. One of the costs to consider is the plan’s premium, and more than a third (36.6%) of Kaiser Permanente’s Medicare Advantage plans are $0-premium plans in 2022 [5].

Medicare star ratings

If you want Medicare’s take on Kaiser Permanente’s plans, look no further than the Centers for Medicare & Medicaid Services' own star ratings, which rank each plan from best (5 stars) to worst (1 star). The agency bases these ratings on plans’ quality of care and measurements of customer satisfaction, and ratings may change from year to year.

Third-party ratings

There are a few companies that weigh in on health plans or on the strength of the company in question, and we’ve included three here:

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