Find information on services and features related to your plan, including coverage information, physician and location directories, member handbooks, and authorization of care forms for you or a loved one.
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If you are a Kaiser Permanente Medicare Advantage member who resides in the counties of Hawaii and Maui and you are unable to obtain services from Kaiser Permanente providers due to the wildfires you may access covered services without a referral and/or from out-of-network providers at in-network cost-sharing.
This flexibility applies from when the Governor of Hawaii issued an emergency proclamation on August 8 until the emergency proclamation ends.
Please call Medicare Member Service Contact Center at 1-800-805-2739, seven days a week, 8 a.m. to 8 p.m. local time, for assistance in accessing care and covered services.
When calling, be sure to notify the member services representative that you’ve been affected by the wildfires.
If you access services from an out-of-network provider during this emergency and receive a bill, you should submit the invoice to KP for payment/reimbursement as appropriate.
- Fit rewards flyer (PDF)
- Fit rewards FAQs (PDF)
Plans purchased through your employer
Individual and family plans
- Patient safety (English) (PDF)
- Patient safety (Chinese) (PDF)
- Annual subscriber notice (PDF)
Summary of benefits and coverage
Summary of benefits and coverage (SBC) documents summarize important information about health coverage options in a standard format developed by Health and Human Services. SBCs allow you to check plan benefits and coverage. You can also easily compare Kaiser Permanente plan benefits and coverage with other carriers.
- Patient request - release of records to patient/third party (PDF)
- Authorization for verbal release of protected health information (PHI) (PDF)
- kp.org "Act for a Family Member" proxy access - adult caregiver (PDF)
- kp.org "Act for a Family Member" proxy access - minor record (PDF)
- Authorization to accompany and consent to limited treatment (PDF)
- Medicare AOR (English) (PDF)
- Medicare AOR (Spanish) (PDF)
- Medicare AOR Large Font (English) (PDF)
- Medicare AOR Large Font (Spanish) (PDF)
- DOL fact sheet #28G - certification of a serious health condition under the family and medical leave act (PDF)
- Patient access request form (PDF)
- Confidential Communication Request (PDF)
Before your visit Forms
Use these forms to help you prepare for your visit to your doctor.
- Consent and conditions of treatment and payment (PDF)
- Family and Medical Leave Act (FMLA) intake form (PDF)
- Medicare secondary payor (MSP) questionnaire (PDF)
- Personal history sheet (PDF)
- For instructions on how to access a video visit, visit the video visit support page.
Enhanced Recovery After Surgery (ERAS)
- Learn to use an incentive spirometer (video)
- What is Enhanced Recovery (video)
- ERAS Recovering After Colon Surgery (PDF)
- ERAS: My Surgery (PDF)
- ERAS: Preparing for a Cesarean Birth (PDF)
- ERAS: Cesarean Birth (PDF)
Health Information
Cancer and nutrition for underweight
- Cancer-Reduce Your risk, adopting a plant-based diet (PDF)
- Nutrition During Cancer Treatment (PDF)
- Prostate Cancer (PDF)
Coping with Depression and Anxiety
- Mild Depression (PDF)
- Moderate Depression (PDF)
- Severe Depression (PDF)
- Mild Anxiety (PDF)
- Moderate Anxiety (PDF)
- Severe Anxiety (PDF)
COVID-19
Diabetes and Prediabetes
- Living with diabetes step by step (PDF)
- Healthy eating - Consistent Carbohydrates for Blood sugar management (PDF)
- Kupu ola diabetes and pregnancy program (PDF)
- Managing Your Child’s Diabetes (PDF)
- Healthy plate : Add Variety (PDF)
- Healthy plate : plant based (PDF)
- Prediabetes, What you should know (PDF)
Digestive
- Constipation (PDF)
- Vomiting and Diarrhea (PDF)
Domestic violence
Heart health
- Healthy Fats for a Healthy Heart (PDF)
- Heart Healthy nutrition (PDF)
- Heart Strong nutrition (PDF)
- Sodium and Heart failure (PDF)
Nutrition
- The Power Up Plate (PDF)
- Maintaining Strong Bones (PDF)
- Fiber Facts (PDF)
- Food and Activity Diary (PDF)
- Healthy Plate: Add Variety (PDF)
- The Mediterranean Healthy plate (PDF)
- The Plant-Based Healthy plate (PDF)
- Using the Healthy Plate for any Cuisine (PDF)
- High Calorie, High Protein Diet (PDF)
- Increase Your Iron intake (PDF)
- Low Potassium Diet (PDF)
- Healthy Eating with Kidney Stones (PDF)
- Dietary Guidelines for Vitamin K and Warfarin (Coumadin) (PDF)
- What’s in your Drink? (PDF)
Pediatric
- 5-2-1-0 (PDF)
- 60 ways to encourage active play (PDF)
- Eat Right , 25 healthy snacks for kid (PDF)
- Feeding Your Toddler (PDF)
- Go, Grow, Glow Healthy plate (PDF)
- Little Changes Big Rewards, Are you ready? (PDF)
- Secret to Portion control is in your hands (PDF)
- Screen time’s effects on kids (PDF)
- What’s in Your Drink (PDF)
- Your family: Be healthy together (PDF)
- Teens – Follow Your Path (PDF)
Physical Activity
- Healthy pregnancy plate (PDF)
- Vaginal swabs (PDF)
Lifestyle medicine
Lifestyle Medicine classes are now available to our members via a virtual format. Members who are interested in attending these classes can call 808-432-2260 to register or request a lifestyle coach who can help identify the most appropriate class for their needs.
The materials required for these classes are included below and should be downloaded and printed for use during the class.