Kaiser Permanente’s national reach – care for 11.8 million members in 8 regions – likely means you’re getting questions from your clients about accessing care at Kaiser Permanente facilities while traveling. Here are the quick facts:
- Kaiser Permanente Washington members are covered for emergency and urgent care while out of the area, no matter what plan they have.
- All Kaiser Permanente Washington members have in-network coverage at Kaiser Permanente Washington facilities.
- All Kaiser Permanente Washington members can receive care at Kaiser Permanente facilities in other Kaiser Permanente regions, but coverage varies depending on a member’s plan. (Care is covered in-network for HMO members who have set up visiting member access, and covered out-of-network for PPO members.)
2 Kaiser Permanente regions in Washington state
There are two Kaiser Permanente regions represented in Washington state. These regions – and all of Kaiser Permanente’s other regions – maintain separate provider and facility contracts and operations.
- Kaiser Permanente Washington: Any Kaiser Permanente facility in Washington state outside of Clark and Cowlitz counties.
- Kaiser Permanente Northwest: Any Kaiser Permanente facility in Washington state located within Clark and Cowlitz counties.
All members can get coverage at any Kaiser Permanente facility, but HMO members need to set up visiting member access prior to seeking care outside of Kaiser Permanente Washington. PPO members do not need to set up visiting member access, but they’ll receive care at their out-of-network benefit level.
Information for Kaiser Permanente Washington HMO members
- Our HMO members can get care for covered services at Kaiser Permanente facilities outside of the Washington region.
- Our HMO members should contact Member Services prior to seeking care in other Kaiser Permanente regions to establish visiting member access.
- For all HMO members (except Medicare Advantage): 1-888-901-4636
- For Medicare Advantage HMO members: 1-888-901-4600
- HMO plans do not include coverage for care with non-Kaiser Permanente providers, other than for emergency and urgent care.
- Medicare Advantage HMO members can get optimized advice from Member Services about care while outside of the Washington region.
Information for Kaiser Permanente Washington PPO members
- The region in which our PPO members obtain routine care affects their coverage level.
- Our PPO members get in-network coverage at Kaiser Permanente facilities in the Kaiser Permanente Washington region.
- Our PPO members get out-of-network coverage at Kaiser Permanente facilities outside of Kaiser Permanente Washington.
- Our PPO members also have in-network and out-of-network coverage for care with other providers both in and out of the Washington region, in addition to the many who practice at Kaiser Permanente facilities.
Helping you help your clients
“Our first goal is always to help our members get the care they need, when they need it,” says Fe’Lecia Boudy, Director, Consumer Experience, Kaiser Permanente Washington Health Plan Operations. “The plans, networks, and contracts associated with each Kaiser Permanente region can be hard for members to understand, which is why our Member Services staff is available to help them. For the best experience, members can call to get the information they need about accessing care while traveling before they head out of the region.”
You can help your clients by explaining Kaiser Permanente’s regions in Washington state and elsewhere, and that access and coverage can vary outside of Kaiser Permanente Washington. Members should always consult their coverage documents for the specifics about coverage while traveling. You can also refer our mutual clients to the Provider and Facility Directory for specifics about their plan’s network.