With the Choice Out-of-Area plan, your employees can receive care from any licensed physician or facility they choose. So they are free to choose whatever provider they prefer, whenever they receive care.
What does the Choice Out-of-Area plan offer?
Care from any licensed provider in the U.S., including physicians, specialists, hospital, or laboratories.
You may have to pay the provider directly at the point of service.
- A claim form may have to be completed. If you are required to pay out-of-pocket at the point of service, you may need to complete a medical claim form and submit it for reimbursement from your insurance carrier.
- You can see any specialist you choose without a referral.
- Certain services require pre-certification.
View Kaiser Permanente Insurance Company’s Sample Coverage Documents:
For future members – To view our sample plan documents, click here (coming soon) and choose the line of business and state from the dropdown menu and review items to assist in your plan choice.
For current members – The sample documents may vary from your actual benefits. To view a copy of your specific plan documents, contact Customer Service at 1-855-364-3184 (TTY 711), Monday through Friday, 8 a.m. to 6 p.m., Mountain time.
- Get the care you need. The Choice Out-of-Area plan empowers you to choose how and where you get covered care.
- Pharmacy services. You can fill your prescriptions at any Pharmacy, including Pharmacies in the MedImpact network. The MedImpact network includes Walgreens, CVS, Kroger, Safeway, Costco, plus hundreds of independent pharmacies nationwide.
Check here for more about pharmacy services, finding doctors and facilities, and the benefits of the Choice Out-of-Area plan.
Is the Choice Out-of-Area plan right for you?
Here’s an example of how members use their Choice Out-of-Area plan to get the care they want:
For employers, the Choice Out-of-Area plan is a great all-in-one solution:
- The versatility and benefits of the Choice Out-of-Area plan can help attract and retain employees.
- Your company has the convenience of one health care provider for all your employee benefits administration.
- Offer it side-by-side with HMO, DHMO, or HDHP plans to decrease your company’s overall health care costs, and still offer your employees plan choice.
How the Choice Out-of-Area plan works for your company and employees.
Members can receive services from any licensed provider or facility. Members pay deductibles, coinsurance, and any difference between the cost of the service and payment provided.
- Choice Out-of-Area plans also include: pharmacy services, worldwide coverage, and personalized case management services for serious health conditions.
- You can fill prescriptions (written by any licensed provider) at any pharmacy across the country.
- You can also fill prescriptions at over 60,000 participating MedImpact pharmacies nationwide, including Costco, CVS, Walgreens, Walmart, Safeway, Albertsons, and Kroger grocery retail stores.
- Learn more about pharmacy services.
- Members must obtain pre-certification for inpatient services, and certain outpatient surgeries, services, and procedures.
- Learn more about pre-certification.
- Please contact your Kaiser Permanente representative.
- Kaiser Permanente Insurance Company (KPIC), a subsidiary of Kaiser Foundation Health plan, Inc., underwrites and processes claims for the Choice Out-of-Area plan.