Kaiser Permanente members: Important information

At kp.org/wa/memberguides, you’ll find our health plan member guides, organized by network name. These guides offer important information on a number of topics:

  • Care locations in your network
  • Primary and specialty care access, including behavioral health and hospital services
  • Urgent and emergency care
  • Getting care after business hours
  • Referral and preauthorization requirements
  • Member rights and responsibilities
  • Travel: care and coverage outside our service area
  • Supportive care services
  • Coverage or service decisions
  • Provider compensation and incentives
  • New medical technology
  • Complaints, appeals, and claims
  • Prescriptions and drug restrictions (pharmacy management procedures)
  • Self-referrals for alternative care and women’s health care
  • Healthy resources
  • Advance directives

Other important information and services

Notice of privacy practices and other disclosures. This notice describes how medical information about you may be used and disclosed, how the information is protected, and how you can get access to this information. To review, go to kp.org/wa/disclosure.

Benefits booklets. Your benefits booklet contains detailed information about the benefits and services covered under your health plan, your plan’s exclusions, and the amount of your copayments and other cost shares for office visits, prescriptions, and other services. For Medicare members, this medical coverage document is called “Evidence of Coverage.” Find yours by logging in to our secure mobile website at kp.org/wa.

Preventive care schedules. Recommended health screenings and immunizations for children and adults are available at kp.org/wa/wellcare.

Language assistance. If you or someone you know needs professional language assistance (such as translation services) in getting health care or plan information, this is available at no extra cost. Please call Member Services and request language assistance.

Kaiser Permanente’s commitment to quality. To help guide the improvement activities we think will help us reach our quality goals, we develop an annual work plan for the organization and monitor our progress and performance throughout the year. For more details on quality, go to kp.org/wa/quality.

Drug formulary. Many Kaiser Permanente plans include coverage for prescription drugs. A formulary is a list of covered medications. Find information about our formulary, including quarterly updates, information on drug restrictions (for example prior authorization, step therapy, quantity limits), procedures for generic substitution, and processes for requesting formulary exceptions at kp.org/wa/formulary.

Provider and facility directory. Obtain information about doctors and other health care providers such as physical therapists, midwives, and alternative care providers who are covered by your plan at kp.org/wa/provider-directory.