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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.
In-network care
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.
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. Out-of-network providers include First Choice Health providers in Alaska, Idaho, Montana, Oregon, and Washington; First Health Network providers in all other states; 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 First Health Network providers will submit the out-of-network 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
- 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
Pharmacy services
- 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.
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.
Wellness tools and resources
Good health. All in one place.
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.