Getting care

Your KP Plus plan gives you access to Kaiser Permanente’s top-rated doctors, clinics, and hospitals, 24/7 virtual care, and the flexibility to get certain services with out-of-network providers a set number of times each year.

In-network care

When you get care in the Kaiser Permanente network, your doctors and specialists are connected and committed to giving you high-quality, personalized care. It all starts with choosing a doctor. Search the doctors and locations directory to browse profiles by gender, language, education, and more — so you can choose a doctor you feel comfortable with and who can be your partner in health. 

  • Your doctors and specialists can access your health history through your electronic health record.
  • Your in-network care generally has the lowest out-of-pocket costs.
  • You won’t have to file claims for reimbursement.
  • Your services are often conveniently located in the same building. 
  • You have access to care in person, by phone or video,1 or through 24/7 virtual care. 

Want to save money on lab tests and imaging? Pay a lower copay or coinsurance at Kaiser Permanente — even if the order came from an out-of-network doctor. Plus, it won’t count toward your out-of-network limit of 10 medical services. 

You can upload a copy of the order on kp.org after accepting the e-visit terms and conditions. We’ll let you know when the lab tests or imaging results are ready. 

Out-of-network care

You can get care from out-of-network providers for up to 10 physician visits or outpatient medical services per year. Get up to 5 fills or refills at out-of-network pharmacies per year.

  • No referrals needed.
  • Some services ― such as inpatient care, outpatient surgery, and advanced imaging ― are only available through Kaiser Permanente and affiliate providers.
  • Your copay or coinsurance may be higher than with in-network providers.
  • You may need to pay the full cost for care at your visit and then submit a claim for reimbursement later.

To submit a claim for reimbursement:

  • Visit kp.org/billing.
  • Go to the "Understand your costs" section.
  • Click "Submit a claim."

For more information, see this flyer on care and prescriptions from out-of-network providers.

Virtual care

You have access to timely care when and where you need it with Kaiser Permanente’s virtual care. Visit kp.org/getcare to learn how you can talk to a clinician 24/7 by phone or video — no appointment needed. You also have quick and convenient options to connect with your care team:

  • 24/7 virtual care and advice
  • Email your care team with nonurgent health questions
  • Scheduled phone and video visits2
  • Online self-service tools (e-visits)
  • kp.org and Kaiser Permanente app
Person getting a prescription from a pharmacist
Pharmacy services

You can fill prescriptions at any Kaiser Permanente pharmacy, as well as any out-of-network pharmacy a limited number of times each year. You’ll generally pay the lowest out-of-pocket costs at in-network pharmacies. Visit the pharmacy services page for details and to find in-network pharmacy locations near you. 

  • You can pick up most prescriptions the same day, or save time and money by having prescriptions delivered to your door at no extra cost.3
  • Visit our drug formulary page to view your plan’s full list of covered medications.

Want to save money on out-of-network prescriptions? Pay a lower copay or coinsurance when you fill them at a Kaiser Permanente pharmacy — even if the prescription came from an out-of-network doctor. Just ask your doctor to send the order to your preferred Kaiser Permanente pharmacy. The prescription won’t count toward your out-of-network limit of 5 prescription fills or refills.

Costs and coverage tools

Easily manage your Kaiser Permanente care costs at kp.org/billing — view and pay medical bills, set up a payment plan, and more. 

Learn how much you could pay for your care with our cost estimate tool.

See what your plan covers and track the number of out-of-network services you have left at kp.org/benefitsummary. You can also track your progress toward your deductible, if your plan has one.

 

A person looking at phone and three mobile app screens
Good health. All in one place.

Download our app for a convenient, secure way to manage the care you get from Kaiser Permanente clinicians. Find urgent care locations, schedule phone and video visits,8 manage prescriptions, view most lab results, and more.

 

Get the app

Footnotes


1When appropriate and available. 
2See footnote 1.
3Not all prescriptions can be mailed, and restrictions may apply. Please check with your local pharmacy.
4The apps and services described above are not covered under your health plan benefits, are not a Medicare-covered benefit, and are not subject to the terms set forth in your Evidence of Coverage or other plan documents. The apps and services may be discontinued at any time.
5Calm and Headspace can be used by members 13 and over. 
6Eligible Kaiser Permanente members can text with a coach using the Headspace app for 90 days per year. After the 90 days, members can continue to access the other services available on the Headspace app for the remainder of the year at no cost.
7See footnote 4.
8See footnote 1. 


Disclaimer

Kaiser Permanente Plus is a limited Point-of-Service (POS) plan with coverage for certain outpatient services and prescriptions from out-of-network providers as described in the Evidence of Coverage.