Forms and publications


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.

Coverage information

Here, you'll find helpful documents related to your plan coverage, such as what to do if you need care while you're traveling, formulary (covered drugs), and patient safety.

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.

Plans purchased through your employer

Individual and family plans

In our effort to assist you in making an informed decision, we are providing plan documents where you can review further details of our plans.

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.

To officially choose someone to help with your complaint or appeal, fill out the form for your membership type and send it to the Member Relations Department.

Non-Medicare:

Make sure to read each part carefully. You need to fill out all of Section A and B. Section C and D must be completed, signed, and dated. If you have a legal representative, they must sign and date Section E, and include the needed legal documents.

Hawaii Quest:

Medicare:

Visit Billing to submit a claim online.

You may also download and complete a Claim Reimbursement Form (PDF).

  • Learn how Kaiser Permanente shares important medical information as part of Health Information Exchange.

 

At Kaiser Permanente, knowing your medical history, such as your active medications and allergies, is critical to help ensure that you receive high-quality care. Advancements in technology support safe and secure electronic exchange of important health information from one health care provider to another, through Health Information Exchange (HIE) networks.

 

Kaiser Permanente participates in several HIE networks with trusted outside health care providers who have electronic medical record systems.

 

HIE participants like Kaiser Permanente are required to comply with specific federal and state laws that protect the privacy and security of your health and personal information. For example, we cannot share certain sensitive health information, including psychotherapy notes and records of substance use disorder, through HIE without first obtaining your written authorization.

 

Under the Health Insurance Portability and Accountability Act (HIPAA), Kaiser Permanente can legally share your health information with your other care providers for the purposes of treatment and care coordination. It is important for your care providers to have timely access to this information so that they have a complete picture of your medical history, reducing the likelihood of conflicting diagnoses, prescriptions, and treatment plans as well as repeated tests or procedures.

 

However, participation in HIE is your choice. You can choose to not have your information shared electronically through HIE (“opt out”) at any time, by filling out the “Health Information Exchange Opt-Out” form available below.

 

For more information, visit the HIE Frequently Asked Questions (FAQ) document or contact the Member Services number on the back of your ID card with any questions.

 

Health related information

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. 

VOG ALERT: What You Need to Know

 

What is VOG?

 

VOG (volcanic smog) forms when sulfur dioxide (SO₂) from volcanic eruptions mixes with sunlight, air, and moisture. It creates haze and tiny sulfuric acid particles in the air, which may irritate the lungs, eyes, and throat.

 

Where is VOG worse?

 

VOG levels depend on volcanic activity, wind direction, and your distance from Kīlauea. Kona and Kaʻū are often hit hardest. When winds shift (especially in winter), areas like Hilo and even other islands can be affected.

 

Who is at risk?

 

  • People with asthma, COPD, or heart conditions
  • Children, elderly, pregnant women
  • Anyone may feel effects like coughing, headaches, or fatigue

 

How to protect yourself:

  • Stay indoors with windows closed; use A/C on recirculate
  • Avoid strenuous activity and drink plenty of fluids
  • Use HEPA air filters to reduce particles (note: filters/masks don’t block SO₂ gas)
  • Track air quality: Visit www.ivhhn.org/vog or listen to local alerts

 

When to call your doctor:

If you have trouble breathing, chest tightness, or if your usual medications aren’t working—call us right away. For severe symptoms, call 911.

 

Stay prepared:

Keep your medications on hand. If you have asthma or lung disease, take your daily medications as prescribed and carry your rescue inhaler (like albuterol) at all times.

 

Questions? Need care?

Call our 24/7 Advice Line: 1-833-833-3333 (TTY: 711)

Or visit kp.org/getcare