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 see out-of-network providers a set number of times each year. 

Care from Kaiser Permanente and affiliated providers

When you get care from Kaiser Permanente, your doctors and specialists are connected and committed to giving you high-quality, personalized care. It all starts with choosing a doctor. Search for doctors and locations in your Options network. 

  • Generally, the lowest out-of-pocket costs.
  • Your doctors and specialists can access your health history through your electronic health record. 
  • Your services are often conveniently located in the same building. 



Care at the out-of-network benefit level

You can get care from out-of-network providers for up to 10 physician visits or outpatient medical services per year. Providers include First Choice Health providers in Washington and in the 2 Idaho counties of Kootenai and Latah; Aetna PPO network providers, offered through Aetna Signature Administrators® anywhere else in the U.S.; and any other licensed provider nationwide. Get up to 5 fills or refills per year through the Optum Rx pharmacy network. 

  • No deductible or out-of-pocket maximum with out-of-network providers. You may be asked to pay when you get care and submit a claim for reimbursement later. 
  • First Choice Health and Aetna PPO network providers will submit claims on your behalf.
  • You don’t need a referral or preauthorization to get care.
  • Some services — including inpatient care and outpatient surgery — are only covered when received from Kaiser Permanente doctors or affiliate in-network providers.
  • Get care from out-of-network providers when traveling.

See what's covered out of network and track your medical visit limits at kp.org/wa/benefits.

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 video1 — 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 questions
  • Scheduled phone and video visits2,3
  • Online self-service tools (e-visits)4
  • kp.org and Kaiser Permanente Washington app
 
Two family members meeting with doctor through tablet device


Pharmacy services

You can fill prescriptions at any Kaiser Permanente pharmacy. You can also fill prescriptions through the Optum Rx pharmacy network 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.5
  • Visit our drug formulary page to view your plan’s full list of covered medications.
 
Person getting prescription from pharmacist in pharmacy

Billing tools

Manage your Kaiser Permanente care costs conveniently — check progress toward your deductible, view and pay medical bills, and more. You’ll also be able to track how many out-of-network services you have available. 

You can also use our no-cost treatment fee and cost calculator tools to stay on top of your medical expenses.

If you’ve paid for care and have a claim for reimbursement, you can find information for submitting your claim in your kp.org account. 


Questions about your coverage and costs?

Check your benefit summary for detailed plan information, including common medical events your plan covers, what you’ll pay for covered services, and any limitations or exceptions there may be for those services.

For more information, see this member overview flyer. 

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,11 manage prescriptions, see lab results, and more.

 
Get the app
Care

Start using your plan

Choose a doctor, transfer prescriptions, and more.

New member welcome

 

Virtual care

Get care

Explore the many ways you can get care virtually anywhere.

Find care

Footnotes

  1. When appropriate and available.  Continue at 1
  2. Online chat with a clinician or mental health specialist, as well as video and phone services, are offered at no additional cost for most health plans. Continue at 2
  3. See footnote 1. Continue at 3
  4. See footnote 2 Continue at 4
  5. Not all prescriptions can be mailed, and restrictions may apply. Please check with your local pharmacy. Continue at 5
  6. The 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. Continue at 6
  7. Calm can be used by members 13 and over. The Headspace Care app and services are not available to any members under 18 years old. Continue at 7
  8. Eligible Kaiser Permanente members can text with a coach using the Headspace Care app for 90 days per year. After the 90 days, members can continue to access the other services available on the Headspace Care app for the remainder of the year at no cost. Continue at 8
  9. The services described above are not covered under your health plan benefits and are not subject to the terms set forth in your Evidence of Coverage  or other plan documents. These services may be discontinued at any time without notice. Continue at 9
  10. See 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 . Continue at 10

Footnotes

1When appropriate and available. 

2Online chat with a clinician or mental health specialist, as well as video and phone services, are offered at no additional cost for most health plans.

3See footnote 1.

4See footnote 2.

5Not all prescriptions can be mailed, and restrictions may apply. Please check with your local pharmacy.

6The 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.

7Calm can be used by members 13 and over. The Headspace Care app and services are not available to any members under 18 years old.

8Eligible Kaiser Permanente members can text with a coach using the Headspace Care app for 90 days per year. After the 90 days, members can continue to access the other services available on the Headspace Care app for the remainder of the year at no cost.

9The apps and services are neither offered nor guaranteed under contract with the FEHB Program, but are made available to enrollees and family members who become members of Kaiser Permanente. 
Some individuals who receive health care services from Kaiser Permanente through state Medicaid programs are not eligible for the Headspace Care app and services. The Headspace Care app and services are not available to anyone enrolled in a fee-for-service Medicaid program. Calm and Headspace Care are not available to Kaiser Permanente Dental-only members. 

10The services described above are not covered under your health plan benefits and are not subject to the terms set forth in your Evidence of Coverage or other plan documents. These services may be discontinued at any time without notice.

11See footnote 1.