Understanding Your Plan and Benefits

In-Network Providers

You have several in-network provider options.

Provider Directory Options by Location:

In Colorado: Find Kaiser Permanente Providers and statewide network of contracted providers.

In Other Kaiser Permanente States:  The 3T POS, PPO, and OOA’s First Health Network provides access to care in the Kaiser Permanente states of CA, 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. Cigna Healthcare 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.

To find an In-Network Provider or confirm if your current provider is In-Network, 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 In-Network providers.

Your choice of In-Network providers is determined by location of services. Please see “Providers by Location”, above, to ensure that your provider is In-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.

When you choose an In-Network Provider, you don’t have to select a personal doctor. You can see Kaiser Permanente, 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 when using an Out-of-Network Provider (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 In-Network provider. However, your In-Network 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
  • Durable Medical Equipment
  • Please review your Certificate of Insurance (COI) for plan details.
• Behavioral health. You can receive care for mental illness, emotional disorders, and substance use disorder.
• Hospital care. You can receive inpatient hospitalization services from In-Network hospitals and facilities. Your In-Network Provider may make arrangements for your hospital admission. (Important! Not all physicians contracted in the In-Network Provider Tier have admitting privileges with In-Network hospitals). Please confirm the facility is contracted with the network or you may pay higher out-of-pocket costs.* To learn more, please visit the 3T POS, PPO, and OOA’s First Health Network.
• Maternity care.  You can choose an In-Network 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 Provider network. You can request that your In-Network Provider send labs, X-rays, and special procedures (MRIs, CT scans, PET scans, nuclear medicine) to a Kaiser Permanente facility, any time you choose.

Pharmacy services. Learn about in-network pharmacy benefits.

To find out more about what is covered In-Network:

• See your Choice PPO New Member Guidebook (Coming Soon).
• 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.–6 p.m., Mountain time, or refer to your ID card.

*Inpatient and certain outpatient services are subject to pre-certification. You must call 1-855-364-3184 (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 Provider Network outside Colorado but inside Kaiser Permanente States, Kaiser Permanente Insurance Company (KPIC) has contracted First Health, a brand name of First Health Group Corp. The list of In-Network First Health providers is subject to change without notice.

KPIC has also contracted with the Cigna Healthcare PPO Network outside of Kaiser Permanente states for health care providers (doctors, hospitals, specialists) contracted as part of the Cigna Healthcare PPO for Shared Administration. Cigna 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’s contractual relationship with the Kaiser Permanente health plans. The Cigna Healthcare PPO Network is provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc.