Federal Employees and Annuitants
2017 Rates and Benefits
Mid-Atlantic States Region
Earn up to a $75 benefit
in healthy rewards.4
Healthy together
See how our care and coverage can help you thrive
kp.org/feds
Not a member yet?
For more information, visit kp.org/feds or call 1-855-315-1004 (TTY: 711),
Monday through Friday, 8 a.m. to 5 p.m.
During open enrollment season, 8 a.m. to 10 p.m.
Kaiser Permanente
Experience the
Kaiser Permanente difference
With Kaiser Permanente1
Without Kaiser Permanente
Choosing
your doctor
Learn about our doctors
by reading their profiles
and biographies on kp.org/
doctor, then choose the
one who’s right for you.
You may not know much
about a doctor. Or you
may be offered a simple
provider directory with
minimal information.
Choosing how
you get care
How, when, and where do you
want to receive care? From
telephone advice to video
visits,1 in-person appointments
to emailing your doctor, and
more, you’re in control.
Even for minor concerns, you
usually make an appointment,
drive to the doctor’s office,
and sit in the waiting room.
Making
a routine
appointment
Use your phone, computer,
or mobile device —
anytime, anywhere.
You’ll likely have to call during
business hours.
Getting medical
advice
Get video medical advice with a
doctor.2 And specially trained
Kaiser Permanente nurses give
medical advice by phone, 24/7.
Both have access to your health
record and can make follow-up
appointments.
If medical advice is available,
the representative won’t have
access
to your medical history and
won’t be able to connect you
directly
to care.
So much in
one place
In most of our facilities, you can
see your doctor, get a lab
test, and pick up prescriptions
under one roof.
Seeing your doctor, getting
a lab test, and picking
up medication probably
means 3 separate trips.
You and your providers have
access to your electronic health
record — which includes your
medical history and most test
results — keeping everyone
connected and in the know.
You have to collect or request
all your medical records
on your own, and your
providers are not likely to be
connected to each other.
We have multilingual doctors
and staff, and we offer
interpretation services by
phone in 150+ languages.
Some health plans offer limited
access to interpreter services
and multilingual doctors.
Viewing your
medical records
and test results
Getting care in
your language
See how our care and coverage can help you thrive
What’s inside this booklet
Check out everything that comes with your health plan, and see why more than
10 million people nationwide choose Kaiser Permanente. Get great care and the
resources you need to live healthier — all in one convenient package.
A healthy partnership............................. P. 2
Great care, great results..................... P. 3
Benefit highlights ....................................... P. 10
Which option is right for you? ........... P. 11
Your 2017 benefits summary .............. P. 12
Care the way you want it .................... P. 4
Ready to enroll with Kaiser Permanente? ....................................... P. 13
Extras for your well-being .............. P. 5
Care for a range of needs................ P. 6
Healthy resources ......................................... P. 7
Locations near you ...................................... P. 8
Once you join …
Visit kp.org/newmember to get started. It’s
easy to choose your doctor, register for kp.org,
and transfer your prescriptions. If you have
questions or need help making your first routine
appointment, just give us a call.
Already a member?
Manage your care online at kp.org. If you
haven’t already, register at kp.org/registernow.
Once you’ve registered, you can email your
doctor’s office with nonurgent questions,
request routine appointments, order most
prescription refills, and more.
1
Kaiser Permanente
A healthy partnership
Your Kaiser Permanente personal physician is the biggest advocate for your health. You
choose your own doctor, and that doctor coordinates your care with specialists as needed.
Culturally responsive care
for diverse communities
Choose your doctor —
and change anytime
At kp.org/doctor, you can find information on
a wide range of top-notch physicians, including
their education, credentials, and specialties.
You can choose your doctor from:
Adult medicine/internal medicine
Family medicine
• Pediatrics/family medicine (children up to 18)
•
•
Select one doctor for your whole family or a
different doctor for each family member.
Quality care starts with quality doctors
No matter which physician you choose, your
health is in highly capable hands. Our doctors
come from top medical schools, and many teach
at world-renowned universities. Because we hire
and train our own doctors, they are all held to
the same quality standards and are committed to
the same vision: Making your life better by being
your trusted partners in total health.
We believe nothing should stand between you
and total health. That’s why we provide care
that’s sensitive to the various ethnicities, cultural
values, and languages of our members. To do
this, we:
Focus on hiring doctors and staff who speak
more than one language
• Offer telephone interpretation services in more
than 150 languages
• Train our providers in how to connect with,
and care for, people of all backgrounds
•
Coordinated and connected care
Your doctor, nurses, and other caregivers work
together as a team, sharing information to give
you the care you need. They’re connected to
each other, and to you, through your electronic
health record. They know your medical history,
test results, medications, and allergies. So you
get personalized care.
Did you know?
In 2015, Kaiser Permanente led the nation in 21 quality care measures, including controlling
high blood pressure, managing diabetes, breast and colon cancer screening, and nutrition and
exercise counseling for children.3 To learn more, visit thrive.kp.org/quality.
2
See how our care and coverage can help you thrive
Great care, great results
Get the care you need to get and stay healthy. From preventive screenings
to care for serious conditions, we’ve got you covered. And your care is backed
by cutting-edge research and advanced medical technology.
Preventive care to keep you healthy
Advanced research
working for you
Prevention plays a vital role in health care. That’s
why we offer so many resources to help you stay
healthy and happy, and avoid getting sick. (For
examples, see “Healthy resources” on page 7.)
We’re always looking to improve care for our
members. Through our ongoing medical
research, we discover new and better ways to
prevent and treat illness.
To catch problems early, we offer preventive
screenings, routine appointments, and more.
Your electronic health record is key, tracking the
services you get and reminding you and your
doctor when you’re due for care.
To make this work possible, we have:
Comprehensive care
when you need it
Along with our commitment to prevention,
we’re here for you if you get sick. You get great
doctors, state-of-the-art facilities, and the
latest technology — all combined to help you
recover quickly.
More than 4,500 studies underway
• 7 regional research centers and 1 national
center
• More than 1,200 research staff members
•
As one of the nation’s largest research programs,
we conduct and share our learnings from
groundbreaking studies and clinical trials.
Our areas of focus span a wide range of health
issues, including cancer, heart disease, diabetes,
childhood obesity, and autism. Learn more at
share.kp.org/research.
If you have a condition such as diabetes or heart
disease, we’ll work with you to manage it using
proven best practices and treatment guidelines.
Our well-rounded approach supports you
physically and emotionally to help you continue
living life to the fullest.
Hear from members about their care experiences
at kp.org/carestories.
3
Kaiser Permanente
Care the way you want it
How, when, and where do you want to receive care? How do you want to manage
your health? When you get care in our facilities, you get what you need for the day
and hour you need it. It’s care that fits your life.
Choose how you connect to care
In
person
Because most of our locations offer many services under one roof, you can see your
doctor, get lab services and X-rays, and pick up your prescriptions — all in one trip.
By
phone
Where telephone appointments are available, you can save yourself a trip to
the doctor’s office and talk with your doctor by phone. And medical advice is
always available by phone 24/7.
By email
You can email your doctor’s office with nonurgent questions and get a reply
usually within 48 hours, often sooner.1
By video
Why not see your doctor by video and save the drive (and paying a share of
the cost)? If you are 18 or older, and have a computer or mobile device with a
built-in camera and microphone, you can meet with your personal doctor from
home, work, or anywhere else. Your video visits are easy, secure, and part of
your coordinated care.
Need something sooner? Video visits are available with an emergency medicine
physician from Kaiser Permanente who is connected to your doctor and your
medical history.2
Choose where you manage your care
4
At home
or work
Stay on top of your care 24/7 through My Health Manager at kp.org. If you
receive care in Kaiser Permanente facilities, you can view your medical record,
refill most prescriptions, schedule and cancel routine appointments, get
vaccination records, see most lab results, and more. Visit kp.org/experience
to see how it works.
On the
go
Wherever you are, you can access most of the features of My Health Manager on
any mobile device through the KP app. You can also find a facility near you and
get directions. Learn more at kp.org/mobile. To use the Kaiser Permanente app,
you must be a Kaiser Permanente member registered on kp.org.
See how our care and coverage can help you thrive
Extras for your well-being
We care for the whole you. From emergencies to personal wellness goals, you get
the support you need to thrive. And to sweeten the deal, we’ll even throw in Visa
reward cards just for taking healthy steps.
Get coverage, no matter
where life takes you
As a Kaiser Permanente FEHB member, your
benefits go further than your home service area.
You’re covered for emergency care anywhere
in the world. We’ll cover Urgent Care at
non–Kaiser Permanente facilities as long as
it can’t wait until you get back home. Just
call our 24/7 Away from Home Travel Line at
1-951-268-3900 or visit kp.org/travel.
• You can receive care from Kaiser Permanente
where our facilities are located in other areas of
the country. Just call Member Services to check
on what services are covered because plans in
other areas vary.
• Students at school out of the service area can
call Kaiser Permanente 24/7 for telephone
medical advice. They are also covered for
emergency care. If a follow-up appointment is
needed after an emergency room visit, it’s easy
to get a referral for that appointment and any
additional lab or imaging services.
•
Help to quit smoking
Let us help you succeed in quitting. You pay
nothing for classes, telephone coaching, online
programs, and prescriptions, including prescribed
over-the-counter tobacco-cessation drugs. Ask
your doctor about your treatment options.
Earn healthy rewards4
Take steps to improve your well-being and earn
up to $150 in rewards to pay for qualified medical
expenses. FEHB subscribers and their enrolled
spouses (age 18 and over) are eligible for the
following rewards:
$50 for taking the Total Health Assessment, an
online questionnaire that gives you a wellness
action plan.
• $25 for completing a healthy lifestyle program,
an online class to help you reach your health
goals.
•
Go to kp.org/feds to learn more and get started.
5
Kaiser Permanente
Care for a range of needs
Get the right care for any situation. We’re just a call or a click away.
Quality care, when and where you need it
6
Emergency care
If you need emergency care, you’re covered worldwide — anywhere, anytime.5
Urgent Care
Urgent Care services are located in many of our medical centers, and 6 are
open 24/7 along with lab, X-ray, and pharmacy. Imagine the convenience of
having the Urgent Care you need under one roof. Visit kp.org/urgentcare/mas
for locations.
Specialty care
Need to see a specialist? We have one of the largest multispecialty medical
groups in the country, so you get access to the right specialist quickly.
You don’t need referrals for some care, including obstetrics-gynecology and
behavioral health.
24/7 nurse
telephone
advice
Have questions? Not sure what kind of care you need? You can call our local
and specially trained Kaiser Permanente advice nurses anytime. If you receive
care in our facilities, the nurses are connected to your doctor, can see your
health record and help figure out what type of care you may need, and even
schedule a routine or Urgent Care appointment for you.
Physician video
advice
When you call for medical advice, you may be able to visit with an emergency
medicine physician from Kaiser Permanente via video. Our advice doctors are
connected to your personal doctor and your medical history.2
Care away
from home
If you get sick or injured while you’re away from home, we can help you
get care. We can also help you prepare for travel by checking if you need
a vaccination, getting you a prescription refill before you leave, and more.
Just call our 24/7 Away from Home Travel Line at 1-951-268-3900 or visit
6
kp.org/travel. (International calls are not toll-free.)
Hospital care
We believe you deserve the best care at all times. And that’s never more
important than when you need a hospital. We carefully select premier
hospitals to partner with us in taking great care of you. Find out who they
are and why we believe their care is better. Visit kp.org/premierhospitals.
See how our care and coverage can help you thrive
Healthy resources
Good health goes beyond the doctor’s office. Take a look at all the healthy
tools and resources available online, by phone, and at our facilities — and
choose the ones that work for you.
Get the most out of your health plan
Online wellness
tools
Visit kp.org/healthyliving for helpful articles, wellness information,
health calculators, fitness videos, music channels, podcasts, and
recipes from world-class chefs.
Healthy lifestyle
programs
Connect to better health. Our online programs can help you lose
weight, quit smoking, reduce stress, sleep better, and more — all at
no cost. Learn more at kp.org/healthylifestyles.
On-site health
classes
Choose from a large variety of classes and support groups and get
help improving your health. Find classes near you at kp.org/classes.
Some classes may require a fee.
Personal wellness
coaching
Work one-on-one by phone with a personal wellness coach — at no
cost. You can get help and inspiration for reaching a variety of health
goals. Find out more at kp.org/wellnesscoach.
Reduced rates
for members
Our members get special rates on a variety of health-related products
and services — like gym memberships, massage therapy, and more.
Check out your options at kp.org/choosehealthy.
Seasonal
farmers markets
Enjoy shopping for fresh, local produce and much more at our farmers
markets hosted at some of our facilities. If food is your thing, visit
kp.org/foodforhealth.
Services are offered by entities other than Kaiser Permanente and are not offered or guaranteed
under any contract. Kaiser Permanente isn’t liable for services provided by the entities. Services can be
changed or discontinued at any time.
7
Kaiser Permanente
Locations near you
It’s easy to get the care you and your family need. There are many
Kaiser Permanente facilities in your area, offering convenient hours and
a wide range of care and services.
Easy access
for easier care
With convenient hours and locations, it’s simple
to get the care you and your family need. Many
of our locations offer same-day, next-day, afterhours, and weekend services.
Most of our facilities offer a variety of care and
services, so you can manage several health care
needs in one visit. You can see your doctor or
specialist, get a lab test or an X-ray, and pick
up your medications — all without leaving the
building.
Getting care
anywhere
With so many locations to choose from, you’re
sure to find one near your home or work —
whatever’s best for you.
You can also see different doctors at different
locations, either for yourself or your family. For
example, you can choose a personal doctor close
to work and an optometrist close to home, and
your child can see a pediatrician near school.
Finding convenient
locations
Choosing the right location is as easy as hopping
online or pulling out your smartphone. Visit
kp.org/kpfacilities to search by ZIP code,
keyword, or the service you want.
Online tours of each of
our medical centers
See each of the places where we care for our
members, from the front door to the pharmacy,
from the exam rooms to the lab, from physical
therapy to where we perform MRIs, and every
place in between. You can choose to look at
still photos or 360o guided photo tours. Visit
kp.org/midatlantic.
New medical centers opening
spring 2017!
Our Severna Park Medical Center will relocate
to Glen Burnie and be named North Arundel
Medical Center. And look for a new medical
center in Harford County, also in spring 2017.
Locations on the next page
Did you know?
We feature more than 500 seasonal, doctor-recommended recipes on our Food for Health blog.
Get inspired at kp.org/recipes.
8
See how our care and coverage can help you thrive
Kaiser Permanente medical facilities
Maryland
Washington, DC
1
2
3
30 Kaiser Permanente Capitol Hill Medical Center
31 Northwest DC Medical Office Building
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
Annapolis Medical Center
Camp Springs Medical Center
Kaiser Permanente Baltimore
Harbor Medical Center
Columbia Gateway Medical Center
Kaiser Permanente Frederick
Medical Center
Gaithersburg Medical Center
Kensington Medical Center
Largo Medical Center
Marlow Heights Medical Center
NEW! North Arundel Medical Center
Opening spring 2017
Prince George’s Medical Center
Severna Park Medical Center
Relocating spring 2017
Shady Grove Medical Center
Silver Spring Medical Center
South Baltimore County
Medical Center
Towson Medical Center
White Marsh Medical Center
Woodlawn Medical Center
NEW! Medical Center in Harford County
Opening spring 2017
83
Harford
Carroll
Baltimore
MD
Frederick
5
16
17
40
270
267
295
13
7
26
66
25
21
31 DC
30
27
9
Anne Arundel
1
50
8
495
2
Prince George’s
29
Prince William
Fauquier
VA
Calvert
95
Charles
Stafford
Virginia
Ashburn Medical Center
Burke Medical Center
Orange
Fair Oaks Medical Center
Falls Church Medical Center
Fredericksburg Medical Center †
Manassas Medical Center
Reston Medical Center
Springfield Medical Center
Tysons Corner Medical Center
Woodbridge Medical Center
10 12
11
23
Fairfax
14
495
28
22
97
95
20
50
695
15
4
6
Culpeper
20
21
22
23
24
25
26
27
28
29
3
Howard
Loudoun
95
Balt City
18
70
Montgomery
19
24
King George
City of
Fredericksburg
Spotsylvania
95
Caroline
These
centers
These
centersoffer
offer 24/7:
24/7:
• Urgent
Care
• Urgent
Care
•
Lab
• Lab
• Pharmacy
• Pharmacy
• Radiology
• Radiology
Westmoreland
Louisa
Hanover
† Not available for Medicare Plus enrollees.
† Not
available for Medicare Plus enrollees.
Please check kp.org/facilities for the most up-to-date listing of the services located at Kaiser Permanente medical centers, or call Member Services.
All Severna Park services and providers will relocate to the new North Arundel Medical Center in spring 2017.
9
Kaiser Permanente
2017 Benefit highlights
$0 copayments for dependents
Other benefit changes
Families choosing the Standard Plan can now
save more with $0 copays for dependents through
age 17.
Key benefit changes to High and Standard
Options include:
•
A $0 copay for specialist consultation prior to
preventive colonoscopy applies to both the
Standard and High Option plans.
•
Benefits added for Applied Behavioral Analysis
(ABA) for children through the end of the
month they turn 19, who have Autism Spectrum
Disorder diagnosis. Copay is same as PCP ($10
for High Option, $20 on Standard Option plans.)
•
We have increased your copayment for
emergency services from $125 to $150.
•
We have removed coverage for in vitro
fertilization.
•
Rewards program Visa card is changing to
a health payment card for qualified medical
expenses.4
•
We increased coverage for rehabilitation and
habilitative therapy by separating visit limits.
Reduced prescription copays
Save money on copays for a 30-day supply of
generic medicines, reduced from $12 to $10
on the Standard Plan. The mail service delivery
program will apply two copayments for up to a
90-day supply.
Take advantage of chiropractic and
acupuncture services
You can receive up to 20 chiropractic visits
per year for the diagnosis and treatment of
neuromusculoskeletal disorders and up to
20 acupuncture visits per year to diagnose and
treat chronic pain and nausea when referred by
your plan physician. You pay $20 per visit (High
Option) and $30 per visit (Standard Option).
Preventive dental care included
With an emphasis on prevention and early
detection of dental problems, your dental
benefit can help you maintain good oral health
and avoid costly procedures in the future.
You pay just $30 per visit for diagnostic and
preventive dental services, which include
oral evaluation, cleaning, and certain X-rays.
Other covered dental services are provided at
a reduced fee. You must receive all your care
from participating Dominion National dental
providers. To learn more, call Dominion member
services specialists at 1-855-733-7524, Monday
through Friday, 7:30 a.m. to 6 p.m. For TTY
for hearing/speech impaired, call 711. Or visit
dominionnational.com/kaiserdentists.
10
To learn more, see the 2017 benefits summary
on page 12; download our Federal Employees
Health Benefits (FEHB) brochure, FEHB formulary
(list of covered drugs), and other material at
kp.org/feds; or call us at 1-855-315-1004 (TTY
711), Monday through Friday, 8 a.m. to 5 p.m. You
can also fill out the reply card at the back of this
brochure to get material.
Eyewear benefits
Whether you choose the High or Standard
Option of care, you pay 75 percent of our
allowance for eyeglass frames, lenses, and a
total contact lens package at Kaiser Permanente
optical centers.
See how our care and coverage can help you thrive
Which option is right for you?
High Option
•
Higher premiums,
with lower copays for
most services and
prescription drugs
If you want low out-of­
pocket costs, this may be
the right choice.
Standard Option
•
Included with Both Options
Lower premiums, but
higher copays for
most services and
prescription drugs
If you want predictable
copays at a lower premium,
or if you have children under
age 18, this may be the right
choice.
•
No copays for
Most preventive care
Emailing your doctor’s office
Video appointments with your
personal care physician (PCP) 2
•
•
•
•
•
•
Video medical advice
with a doctor 2
No deductible
$30 preventive care dental benefit
Eyewear coverage
No paperwork or bills when you
get care in Kaiser Permanente
facilities
Covered for emergency care
worldwide
Access to a range of health and
wellness classes at Kaiser
Permanente medical centers and
online, most at no cost
Our Medicare health plan members
get better benefits
Discounts and savings for
additional health care services
If you have Medicare and decide to enroll in Kaiser
Permanente Medicare Plus (Cost) for Federal
members, you’ll get richer benefits than with your
FEHB coverage alone. Learn all about the different
parts of Medicare and how they work together
in Your Guide to Choosing a Kaiser Permanente
Medicare Health Plan. Download our brochure at
kp.org/feds, or to have one sent to you, please
call Member Services at 1-888-777-5536 (TTY 711),
7 days a week, 8 a.m. to 8 p.m.
ChooseHealthy™ You’ll receive discounts off
regular rates for services such as massage
therapy and acupuncture, and get preferred
rates on select fitness club memberships.7
You’ll also get no-cost shipping on purchases of
vitamins and herbal supplements. Learn more at
kp.org/choosehealthy or call 1-877-335-2746.
11
Kaiser Permanente
Your 2017 benefits summary
Benefits and Services
High Option
Standard Option
$0
$0
Primary care
$10/$0 through age 4
$20 adult / $0 through age 17
Specialty care
$20
$30
Lab tests and X-rays
$0
$0
Specialty scans
$75
$100
Chiropractic services (up to 20 visits per year)
Hospital and facility
$20
$30
Outpatient surgery
$75
$150
Inpatient hospital care (per admission)
Maternity
$100
$250 per day up to $750
$0
$0
Delivery (per admission)
Emergency and Urgent Care (per visit or trip)
$100
$250 per day up to $750
Emergency care
$100
$150
Urgent Care
$20
$30
Outpatient services (per visit or procedure)
Preventive care
Routine prenatal care visit, first postpartum visit
Ambulance
$0
Prescription drugs (up to a 30-day supply at plan pharmacies. See page 8 for mail-order discounts.)8
$100
Generic
$7
$10
Preferred brand
$30
$35
Non-preferred brand
$45
$65
20% up to $100
30% up to $150
$2,250 per person
$3,500 per person
High Option
Standard Option
Biweekly Non-Postal
$74.50
$55.85
Biweekly Postal Category 1
$65.27
$48.59
Biweekly Postal Category 2
$62.19
$46.36
Monthly Non-Postal
$161.41
$121.01
Biweekly Non-Postal
$193.57
$126.22
Biweekly Postal Category 1
$173.74
$109.81
Biweekly Postal Category 2
$167.14
$104.76
Monthly Non-Postal
$419.40
$273.47
Biweekly Non-Postal
$187.84
$130.69
Biweekly Postal Category 1
$166.78
$113.70
Biweekly Postal Category 2
$159.77
$108.47
Monthly Non-Postal
$406.99
$283.16
Specialty
Out-of-pocket maximum (2x per family maximum)
Your Premium Share
9
Self
Only
Self
Plus
One
Self
and
Family
12
See how our care and coverage can help you thrive
Ready to enroll with Kaiser Permanente?
1. Choose an option.
•
•
High Option
Standard Option
Find brief descriptions of
these options on page 11.
More details about benefits
and rates are on page 12.
2. Select the type of
enrollment you want.
•
•
•
Self Only covers you.
Self Plus One covers
you and one eligible
family member.
Self and Family covers
you and all eligible
family members.
3. Sign up online or call.
Find your enrollment code in the
chart below. Then, visit opm.gov
to enroll online or contact your
employing agency or retirement
office for next steps and other
information.
Annuitants can contact the
Retirement Information Center at
1-888-767-6738 or 1-855-887-4957
(TTY), or [email protected].
If you qualify for Medicare, or will soon, see page 11 for more information.
Self Plus One
Self Plus One is available for enrollees to cover
themselves and one eligible dependent. Or,
you may choose to enroll in Self and Family. You
decide which enrollment type is best for you.
If you choose the High Option, you will pay a
lower premium if you enroll in Self and Family. If
you choose the Standard Option, you will pay a
lower premium if you enroll in Self Plus One.
All FEHB enrollees can make enrollment changes
during Open Season, when you experience a
qualifying event, or during a Special Enrollment.
If you are a retiree, you have the additional
option to decrease your enrollment type
throughout the year.
To move from Self and Family to Self Plus One,
you must change your enrollment by following
Step 3 above.
Choose the right enrollment code
Enrollment Code
Self Only
Self Plus One
Self and Family
High Option
E31
E33
E32
Standard Option
E34
E36
E35
Need help? Call us at 1-855-315-1004 (TTY 711), Monday through Friday, 8 a.m. to 5 p.m.
These are highlights of the FEHB enrollment process. Please refer directly to opm.gov and your employing agency or retirement
office for FEHB coverage effective dates, enrollment procedures and deadlines, and other information. To add an eligible family
member to your Kaiser Permanente Self and Family, complete and return an Enrollment Change Form to us. These forms can be
obtained at kp.org/feds or by calling Member Services.
13
The right choice for a healthier you
Having a good health plan is important. So is getting quality care.
With Kaiser Permanente, you get both.
Learn more about how health care and coverage work together,
for you.
• Member Services
1-855-315-1004 (TTY 711)
Monday through Friday, 8 a.m. to 5 p.m.
• kp.org/feds
Stay connected to good health
facebook.com/kpthrive
youtube.com/kaiserpermanenteorg
@kpthrive, @kpshare, @kptotalhealth, @kpmidatlantic
End notes:
1
These features are available when you get care at Kaiser Permanente facilities.
²Video appointments with primary care physicians (PCPs) available only with Permanente physicians.
During a PCP visit, you must be present in Maryland, Virginia, or Washington, DC. For urgent medical
advice video visits, you may also be located in Florida, North Carolina, West Virginia, or Pennsylvania.
For members 18 and older. For certain medical conditions.
³ Kaiser Permanente 2015 HEDIS® scores. Benchmarks provided by the National Committee for
Quality Assurance (NCQA) Quality Compass® and represent all lines of business. Kaiser Permanente
combined region scores were provided by the Kaiser Permanente Department of Care and Service
Quality. The source for data contained in this publication is Quality Compass 2015 and is used with the
permission of NCQA. Quality Compass 2015 includes certain CAHPS® data. Any data display, analysis,
interpretation, or conclusion based on these data is solely that of the authors, and NCQA specifically
disclaims responsibility for any such display, analysis, interpretation, or conclusion. Quality Compass®
and HEDIS® are registered trademarks of NCQA. CAHPS® is a registered trademark of the Agency for
Healthcare Research and Quality.
4
The rewards program runs from January 1 through December 31, 2017, and is open to all Kaiser
Permanente FEHB subscribers and their enrolled spouses 18 and older. You can take the Total Health
Assessment as often as you like and as many healthy lifestyle programs as you want, but you can
only earn rewards for them once during the reward period. You must complete the activities during
the calendar year. Reward cards expire 12 months from the date issued. We will send each eligible
member a Kaiser Permanente Health Payment Card 4–6 weeks after you complete your first activity,
then load additional rewards when you complete your second activity. You must keep your card for use
throughout the year and use rewards you earn to pay qualified medical expenses by March 31 of the
next calendar year. Go to kp.org/feds to learn more and get started.
5
If you reasonably believe you have an emergency medical condition, which is a medical or psychiatric
condition that requires immediate medical attention to prevent serious jeopardy to your
health, call 911 or go to the nearest emergency department. For the complete definition of an
emergency medical condition, please refer to your Evidence of Coverage.
6
This number can be dialed from inside and outside the United States. Outside, you must dial the U.S.
country code “001” for land lines and “+1” for mobile before the phone number. Long-distance charges
may apply and we cannot accept collect calls. This phone line is closed on major holidays.
7
This value-added service is an extra service provided by entities other than Kaiser Foundation Health
Plan of the Mid-Atlantic States, Inc. (KFHP-MAS), and is neither offered nor guaranteed under any
KFHP-MAS contract. This entity may change or discontinue offering this service at any time. KFHP-MAS
disclaims any liability for the service provided by this entity.
8
Plan providers determine the drug that is medically necessary. If you request another drug, you pay
prices charged to members for non-covered drugs.
9
These rates do not apply to all enrollees. If you are in a special enrollment category, please contact the
agency or Tribal Employer which maintains your health benefits enrollment.
Kaiser Foundation Health Plan
of the Mid-Atlantic States, Inc.
2101 E. Jefferson St.
Rockville, MD 20852
60496708 MAS 10/1/16-12/31/17
This is a summary of the features of the Kaiser Permanente health plan. Before making a final decision,
please read the plan’s federal brochure (RI 73-047). All benefits are subject to the definitions, limitations,
and exclusions set forth in the federal brochure. The benefits listed on page 7 (“Healthy resources,” except
“Health classes”) and on page 11 (discounts and savings for additional health care services) are neither
offered nor guaranteed under contract with the Federal Employees Health Benefits (FEHB) Program, but
are made available to all enrollees and family members who become members of Kaiser Permanente.
Notice of Summary of Benefits and Coverage (SBC): Availability of Summary Health Information
The FEHB Program offers numerous health benefits plans and coverage options. Choosing a health
plan and coverage option is an important decision. To help you make an informed choice, each FEHB
plan makes available an SBC about each of its health coverage options, online and in paper. The SBC
summarizes important information in a standard format to help you compare plans and options. This
plan’s SBC is available on the Internet at kp.org/feds. A paper copy is also available, free of charge, by
calling 1-855-315-1004. For TTY, call 711. To find out more information about plans available under the
FEHB Program, including SBCs for other FEHB plans, please visit opm.gov.
©2016 Kaiser Foundation Health Plan, Inc.