Welcome to
Kaiser Permanente!

Provider and Care Options

Your Plan provides exclusive access to care from Kaiser Permanente Network Providers and Non-Network Providers (for a select number of services, see your Summary of Benefits and Coverage for more information). We work together to create a personalized wellness plan that makes it easier for you to stay healthy — in mind and body.

• Network Providers: To find a Kaiser Permanente Network Provider, visit kp.org. You can also visit the following urgent care clinics and pay your normal copay or coinsurance.
  • Minute Clinic in Arizona, Connecticut, Florida, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas and Wisconsin. 
  • Concentra in Arizona, Arkansas, Connecticut, Delaware, Florida, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, and Wisconsin. 
  • The Little Clinic  (TLC) in Arizona, Indiana, Kansas, Kentucky, Ohio, Tennessee 
• Non-Network Providers: Your plan includes a select number of services/visits* with any other licensed provider. For qualified services and details, refer to your Summary of Benefits and Coverage in the Resources and Forms section to the right. Note: Plan name can be found within the Schedule of Benefits section of the Benefit Booklet from your employer.
  • Key services/items that count as services/visits:
    • Routine office visits, including primary, preventive and specialty care, mental health and chemical dependency visits
    • Diagnostic lab tests and X-rays
    • Physical, occupational, and speech therapy office visits
    • Allergy injections received at an office

*Services/Visits – one visit may include multiple services. For Example:  If you see a Non-Participating Provider and the provider orders a lab test done in his/her office, this will count as two Plus visits.

This is just a summary. Plan coverage and cost shares vary based upon benefit and provider selection. Please refer to your Summary of Benefits and Coverage, Benefit Booklet or other Plan documents for more information.

Pharmacy Options

• Network: Members have access to Kaiser Permanente Pharmacies. To locate a Kaiser Permanente pharmacy, log into kp.org and select Pharmacy.
• Non-Network: Members have access to any other licensed pharmacy for certain prescriptions. Limitations and exclusions will apply. Refer to your Summary of Benefits and Coverage or Benefit Booklet for additional details.

You can also see a list of your plan’s Drug Formulary (Covered Drugs) at kp.org. Select the Self-Funded/Level Funded Drug Formulary from the list on kp.org and go to the information you are seeking (formulary drug list, specialty drug list, or preventive drug list).

Care While Traveling

Members who are traveling away from home can plan ahead by visiting Health Care Away from Home. 24/7 care is available from Kaiser Permanente health care professionals by phone or video (when appropriate and available).

Contact Information

• Customer Service 1-800-401-8405 (TTY 711)
• Appointments and medical advice 1-800-218-1059
• Pharmacy information 1-866-427-7701

Provider and Care Options

To make an appointment please select a provider according to the appropriate Tier. For questions regarding your plan or Tier type, please contact Customer Service.

• EPO In-Network Provider Tier: You have access to Kaiser Permanente Providers. To find a provider, log into kp.org.
• Participating Providers (PPO Providers) Tier:
  • You may select a provider from First Health Network Participating Providers (for service in Kaiser Permanente states: CA, CO, GA, HI, MD, OR, VA, WA, and DC).
  • In all other states to find network providers and facilities, visit the Cigna Healthcare^SM PPO Network* provider directory.  You will receive a bill later for your regular copay or coinsurance.
  • Some services may require pre-certification to be covered, such as inpatient care (for example: hospital surgical procedures) and some outpatient procedures. If using the First Health Network (in Kaiser Permanente states) and Cigna PPO Network (in non-Kaiser Permanente states) for care, the First Health Network providers and Cigna PPO providers are responsible for obtaining pre-certification on your behalf when pre-certification is required. You won’t be financially responsible if First Health Network and Cigna PPO providers fail to obtain pre-certification for covered services. 
  • You can also visit the following urgent care clinics and pay your normal copay or coinsurance.
    • Minute Clinic in Arizona, Connecticut, Florida, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas and Wisconsin.
    • Concentra in Arizona, Arkansas, Connecticut, Delaware, Florida, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, and Wisconsin.
    • The Little Clinic in Arizona, Indiana, Kansas, Kentucky, Ohio, Tennessee
• Non-Participating (Out-of-Network) Provider Tier: Any other licensed provider.

Cost shares may vary by Tier: Check your Summary of Benefits and Coverage (SBC) for details.

*The Cigna Healthcare PPO Network refers to providers (doctors, hospitals, specialists) contracted as part of the Cigna Healthcare PPO Network for Shared Administration.

Pharmacy Options

• In-Network Pharmacy Tier 1: You have access to Kaiser Permanente pharmacies.
• Participating Pharmacy Tier 2: You have access to OptumRx pharmacies.
• Non-Participating Pharmacy Tier 3: You have access to any other pharmacy.

Members may fill a prescription written from any provider, at any pharmacy option listed above. Cost shares and fill quantity may differ by Tier: Check Plan for details.

Pharmacy locator: Kaiser Permanente and OptumRx pharmacy locations can be found at kp.org.

To see a list of your Plan’s covered drugs go to Drug Formulary (Covered Drugs).

Contact Information

• Customer Service 1-800-401-8405 (TTY 711)
• Appointments and medical advice 1-800-218-1059
• Pharmacy information 1-866-427-7701

Provider and Care Options

• Participating Provider Tier 1:
  • You may select a provider from First Health Network Participating Providers (for service in Kaiser Permanente states: CA, CO, GA, HI, MD, OR, VA, WA, and DC).
  • In all other states to find network providers and facilities, visit the Cigna Healthcare^SM PPO Network* provider directory.  You will receive a bill later for your regular copay or coinsurance.
  • Some services may require pre-certification to be covered, such as inpatient care (for example: hospital surgical procedures) and some outpatient procedures. If using the First Health Network (in Kaiser Permanente states) and Cigna PPO Network (in non-Kaiser Permanente states) for care, the First Health Network providers and Cigna PPO providers are responsible for obtaining pre-certification on your behalf when pre-certification is required. You won’t be financially responsible if First Health Network and Cigna PPO providers fail to obtain pre-certification for covered services. 
  • You can also visit the following urgent care clinics and pay your normal copay or coinsurance.
    • Minute Clinic in Arizona, Connecticut, Florida, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas and Wisconsin.
    • Concentra in Arizona, Arkansas, Connecticut, Delaware, Florida, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, and Wisconsin.
    • The Little Clinic (TLC) in Arizona, Indiana, Kansas, Kentucky, Ohio, Tennessee
• Non-Participating Provider Tier 2: Any other licensed provider.

Cost shares may vary by Tier: Check your Summary of Benefits and Coverage (SBC) for details. 

*Disclaimer: The Cigna Healthcare PPO Network refers to providers (doctors, hospitals, specialists) contracted as part of the Cigna Healthcare PPO Network for Shared Administration.

Pharmacy Options

Colorado Level Funded PPO members can fill a prescription written by any licensed provider at a Kaiser Permanente Pharmacy, or any licensed pharmacy (please note cost shares differ per selection).

• Participating Pharmacy Tier 1: OptumRx pharmacies. Register on OptumRx.com (using Kaiser Permanente Member Record Number to locate participating pharmacies).
• Non-Participating Pharmacy Tier 2: Any other pharmacy. Note: you may need to pay out of pocket, then be reimbursed using the OptumRx Pharmacy Claim Form (see Resources and Forms to the right).

Members may fill a prescription written from any provider at any pharmacy option listed. Cost shares may vary by Tier: Check your Benefit Booklet or Summary of Benefits and Coverage for details. 

To see a list of your plan’s covered drugs go to Drug Formulary (Covered Drugs) and select the Colorado Level Funded PPO/POS formulary.

Contact Information

• Customer Service 1-800-401-8405 (TTY 711)
• Appointments and medical advice 1-800-218-1059
• Pharmacy information 1-866-427-7701