Understanding Your Plan and Benefits

Participating Provider Tier

You have two network options within the Participating Provider Tier. 

Starting 1/1/2023 Provider Directory Options by Location:

In Colorado:  Find Network providers and locations

In Kaiser Permanente States:  The 3T POS, PPO, and OOA’s First Health Network provides access to care in the Kaiser Permanente states of CA, CO, GA, HI, MD, OR, VA, WA, and DC.

Non-Kaiser Permanente States:  The Cigna Healthcare^SM PPO Network* only provides access to care in non-Kaiser Permanente states.

*Disclaimer:  The Cigna Healthcare PPO Network refers to the health care providers (doctors, hospitals, specialists) contracted as part of the Cigna Healthcare PPO for Shared Administration.

To find a Participating Provider or confirm if your current provider is part of the Participating Provider Tier, you can search for Providers by location (Kaiser Permanente and non-Kaiser Permanente states) or call Customer Service at 1-855-364-3184 (TTY 711), Monday through Friday 8 a.m.-6 p.m., Mountain time.

Features and benefits of covered care from our participating provider networks.

Your choice of participating provider is determined by location of services.  Please see “Providers by Location”, above, to ensure that your provider is part of the Participating Provider Network.  You may also call Customer Service at 1-855-364-3184 (TTY 711), Monday through Friday 8 a.m.-6 p.m., Mountain time.

In the Participating Provider Tier, you don’t have to select a personal doctor.  You can see First Health or Cigna PPO Network health providers without a referral.

• Out-of-pocket costs. You will probably have lower out-of-pocket costs than in the Non-Participating Tier (such as a deductible, coinsurance, and a copay), and you will not be responsible for the amount you are billed above the maximum allowable charge set out in your Certificate of Insurance (COI).
• Specialty care.  You don’t need a referral for specialty appointments with any participating providers.  However, your Participating Provider must obtain pre-certification for certain services and treatments* such as:
  • Inpatient hospital stay
  • Outpatient surgery
  • Home health, hospice, and skilled nursing facility services
  • Imaging services
  • Please review your Certificate of Insurance (COI) for plan details.
• Behavioral health.  You can receive care for mental illness, emotional disorders, and drug or alcohol abuse from Participating Providers.
• Hospital care. You can receive inpatient hospitalization services from Participating Provider hospitals and facilities.  Your Participating Provider may make arrangements for your hospital admission.  (Important! Not all physicians contracted in the Participating Provider Tier have admitting privileges with participating hospitals).  Please confirm the facility is contracted with the network or you may pay higher out-of-pocket costs.*  To learn more, please click here.
• Maternity care.  You can choose a Participating Provider for your obstetric care.*
• Lab tests, X-rays.  You can contact facilities directly.  Check first to be sure the facilities are part of the Participating Provider network.  You can request your Participating Provider to send labs, X-rays, and special procedures (MRIs, CT scans, PET scans, nuclear medicine) to a Kaiser Permanente facility, an HMO In-Network Provider, any time you choose, and you will likely pay less.
• Pharmacy services. Learn about pharmacy benefits in the Participating Provider Tier.

To find out more about what is covered under the Participating Provider Tier:

• See your CO PPO New Member Guidebook.
• Refer to your Certificate of Insurance (COI).
• Contact the human resources/benefits officer where you work, if your employer provides your coverage.
• Call Customer Service at 1-855-364-3184 (TTY 711), Monday through Friday, 8 a.m. to 6 p.m., Mountain time, or refer to your ID card.

2025-26 COVID-19 vaccine 

The COVID-19 vaccine is the best way to keep you and your family safe from the virus. Learn how to get the vaccine and why it’s both safe and effective. The 2025–26 COVID-19 vaccine is available at no cost for Kaiser Permanente members 6 months and older. Members can walk in to get the vaccine. Each year, our experts review the latest scientific evidence and consider clinical guidance from many sources including leading medical societies to develop our COVID-19 vaccine guidance. Vaccination remains one of the safest and most effective ways to help protect against severe illness. This includes children and families whose health would be at risk if they got COVID-19.

File a Complaint

Members have the right to file a complaint with either Administrator or the state of Colorado regarding the accuracy of the provider directory and/or their experience with a provider.
To file a complaint, members may do so by phone or by mailing their concerns to the address listed.

Contact Customer Service:
Phone 1-855-364-3184 (TTY 711), Monday through Friday, 8:00 a.m. to 6:00 p.m., Mountain time, or refer to the ID card.

Write to the Administrator:
Kaiser Permanente Insurance Company
P.O. BOX 370897
Denver, CO 80237-0987

To submit a complaint with the Division:
Colorado
Department of Regulatory Agencies (DORA)
Division of Insurance (DOI)
https://doi.colorado.gov/for-consumers/file-a-complaint
Phone 1-303-894-7490 / 800-930-3745 (outside the Denver Metro area)/ DORA_Insurance@state.co.us
Monday – Friday, 8:00 a.m. – 5:00 p.m.

*Inpatient and certain outpatient services are subject to pre-certification. Your Participating Provider must call 1-888-525-1553 (TTY 711) for pre-certification.

This site provides an overview of your benefits and services. If there are any differences between this document and your Certificate of Insurance (COI), your Certificate of Insurance (COI) will prevail.

For its Participating Provider Network, Kaiser Permanente Insurance Company (KPIC) has contracted First Health, a brand name of First Health Group Corp.  The list of participating First Health providers is subject to change without notice.

The Cigna Healthcare PPO Network refers to the health care providers (doctors, hospitals, specialists) contracted as part of the Cigna Healthcare PPO for Shared Administration.Cigna Healthcare^SM is an independent company and not affiliated with Kaiser Foundation Health Plan, Inc., and its subsidiary health plans.  Access to the Cigna Healthcare PPO Network is available through Cigna Healthcare’s contractual relationship with the Kaiser Permanente Health Plans. The Cigna Healthcare PPO Network is provided exclusively by or through operating subsidiaries of The Cigna Group, including Cigna Health and Life Insurance Company. The Cigna Healthcare name, logo, and other marks are owned by Cigna Healthcare Intellectual Property, Inc.