Frequently Asked Questions About Kaiser Permanente
These are answers to some common questions from members, arranged by category. If you don't find the help you need, contact Member Services.
- Obtain care from certain out-of-network providers at in-network cost-sharing
- Obtain care without a referral in cases where a referral would normally be required
- Obtain Part D medication refills sooner and in larger quantities than typically allowed
You may view profiles of doctors and other providers in the Provider Directory.
Submit your choice online: To choose your primary care provider online, you must sign on. In the Provider Directory, click on the name of the provider you want, and the blue button called “Select as PCP" will open a short form for you to fill out and submit.
By phone: You also may call Member Services during business hours, Monday through Friday, to designate a personal physician.Choose or Change Your Personal Physician
You may change your primary care doctor at any time. Just select someone else as your personal physician. Sign on, go to that doctor's profile page in the Provider Directory, and submit the online form called "Make this doctor my personal physician." You also may change personal physicians by calling Member Services.
Also see, Choose or Change Your Personal Physician
If you want to see a doctor at a Kaiser Permanente medical offices location, call the medical center where the doctor is based. If you are registered on the Kaiser Permanente member website, you can schedule the appointment online by signing on and going to the Appointments link on your secure home page.
If you want to see a doctor in our network (doctors who don't work at a Kaiser Permanente-owned clinic), call that medical clinic to make an appointment. If you are seeing a specialist in the network, you may need a referral, also called an authorization.Making Appointments
Kaiser Permanente members can make appointments directly with most specialists at Kaiser Permanente medical offices locations without a referral (authorization) from their personal physician.
To see a contracted or network specialist who doesn't work at a Kaiser Permanente-owned facility, an authorization from your health plan may be needed.How to Get Specialty Care
In a life-threatening situation, always call 911.
For non-life threatening situations after hours, call our Consulting Nurse Service. (The number also is on the back of your Kaiser Permanente member ID card.) The consulting nurse will give you advice on how to best treat your condition and, when necessary, recommend that you go to a Kaiser Permanente Urgent Care Center or an emergency room.
If your question or concern is not urgent, you can sign on to this site and send a secure e-mail message, either to your health care team or to our Consulting Nurse Service. You should get a reply by the end of the next business day. (You must be registered on Kaiser Permanente member website to access these services.)Consulting Nurse Service
If you are injured on the job, tell your employer immediately and complete any necessary internal forms.
When you first visit your doctor for this injury, tell the medical receptionist that you have a work-related injury. Be sure to complete workers' compensation forms, including a report of the accident. This will help us bill the appropriate insurance carrier. If you have questions about on-the-job injury claims, contact Member Services.
If the Governor of Washington, the U.S. Secretary of Health and Human Services, or the President of the United States declares a state of disaster or emergency in your geographic area, you are still entitled to coverage from your plan.
Generally, during a disaster your coverage will be temporarily expanded and allow you to:
When the disaster is over (as announced by government officials or, if there is no announcement, 30 days after the disaster was declared), plan benefits and policies return to normal.
If you have questions about coverage during a disaster, please call us.
Mon.-Fri., 8 a.m.-5 p.m.
Medicare Member Services
TTY WA Relay
1-800-833-6388 or 711
Mon.-Fri., 8 a.m.-8 p.m.
Extended hours (Medicare Member Services)
Oct. 1 - Feb. 14
8 a.m. - 8 p.m.
7 days a week
When you enrolled, you received a benefit summary (also called a certificate of coverage) that lists most covered services. If you are registered on Kaiser Permanente member website, you can sign on and see information for specific visits in the Health Coverage area. The Benefits Usage Status link shows how much of your optical or other benefits have been used in the current year.
If you have a coverage question that is not answered in the benefit summary, or you are unsure of what your plan covers, contact Member Services.
Most plans cover prescription drugs. Sign on and check your certificate of coverage or other coverage agreement for your prescription benefits.
If you have questions about whether a prescription you are currently taking will be covered, check our online Drug Formulary.About Our Drug Formulary
You have 60 days after a baby's birth to register your child for coverage. If you receive coverage through your employer, contact the benefits or personnel department where you work to add your child.
If you're on a plan that you purchased directly (not through an employer), see the Individual and Family Plans section.
If your coverage is through the Washington Basic Health Plan, go to the Washington Health Benefit Exchange website for contact information.
Kaiser Permanente members are covered for emergency and urgent care while traveling anywhere in the world. This coverage is described in your Kaiser Permanente certificate of coverage or medical coverage agreement.
If you or a family member is admitted to a hospital while traveling, you must call our Hospital Notification Line at 1-888-457-9516 within 24 hours to notify us or to request follow-up care.
While traveling outside the Kaiser Permanente coverage area in the United States, some of our health plans provide care at Kaiser Permanente facilities. Check your coverage.When You Are Traveling
If you receive your coverage from your employer, contact your benefits or personnel department at work to see if you are eligible for dental benefits. Members on most individual and family plans and on Medicare plans have the option to include dental coverage when they enroll in medical coverage.Dental Coverage
Your employer determines the end date of your coverage and notifies Kaiser Permanente. Contact your employer for information about any continuation of benefits (such as COBRA) that may be available to you.
You may also enroll in one of our individual and family plans.Individual & Family Plans
Kaiser Permanente members who attend college in Washington are covered at Kaiser Permanente facilities in western Washington and the Spokane area, and through our networks in those areas, if included in your health plan.
Members attending schools in other states are covered for urgent and emergency care only. Check your certificate of coverage because the age for qualifying as a dependent varies between plans.
Online Services (Kaiser Permanente member website)
If you completed registration, call Member Services to get all your services switched on right away.
Here are the reasons you may not see all services after finishing the registration:
1. If you don't get your primary care at a Kaiser Permanente medical office location, you will only have some online services. You'll be able to refill prescriptions online, get a Health Profile assessment, and check your health coverage and benefits online. However, you won't be in the system that allows you to e-mail Kaiser Permanente doctor, or make appointments and see lab results online.
2. You chose a primary care doctor after you registered. To have the rest of your services activated, call Member Services during business hours, Monday through Friday.
3. You haven't chosen a personal physician yet. (See the first question in the Getting Care section on this page.)Member Services
You can request online access if your children, birth through age 17, receive care at a Kaiser Permanent medical office. First, you must register with this member website so you have access to your own online records. Then print and fill out a form for each child for whom you want access, and follow the instructions.
(If you aren't a Kaiser Permanente member but your child is, contact Member Services for assistance.)How to request parental access
After you sign on to the Kaiser Permanente member website, click on Messages on your secure home page and you'll see the "E-mail Your Health Care Team" link. The Messages link also is in the left column of any page on the secure site. (You cannot e-mail a doctor through the Provider Directory.)
Secure messaging only is available with doctors and other providers you have seen at Kaiser Permanente medical offices clinics.
You have to register for Kaiser Permanente member website to order refills online.
If your prescription is at a pharmacy that isn't owned or operated by Kaiser Permanente, you will need to transfer the prescription to Kaiser Permanente. You can do that online by signing on and going to the Medications area on your secure home page. Or you can print the form and mail or fax it to us.
If you are using an older Safari browser, you may have started having problems with our Pharmacy online refills in early 2015. Some members got online messages to keep signing on or that they couldn’t use a credit card.
We apologize for the inconvenience. You can solve the problems by updating to a more recent version of Safari. You also can call our automated Pharmacy line to place a refill order at 206-901-4444 or 1-800-245-7979
Make sure that Kaiser Permanente has your current e-mail address.
To check or change your e-mail, sign on and go to the communication preferences link at the top left of your secure home page. If the e-mail address is correct but you're not getting notifications, call Member Services to report the problem.
For most secure messages, you can only reply for 30 days. After a month, the Reply button disappears but if the person is in your e-mail list, you can create a new message.
Sometimes, a new message doesn't have a reply button. For example, if another doctor is filling in for your regular doctor during vacation, a reply button won't display.
Passwords and Access
You'll be locked out if you have 5 unsuccessful attempts to sign on. The lock-out is a security measure to protect against hackers. A lock-out usually happens because someone isn't aware they incorrectly entered their member ID number or password.
The 5 attempts don't have to occur at the same time. Maybe you tried 3 times last week, and then you tried 2 times today and couldn't sign on, and that added up to the limit of 5 consecutive failed attempts. (The count goes back to zero when you do successfully sign on.)
To get access again, follow the instructions on the error page you see when you try to sign on. Our system can send a temporary password to your personal e-mail address so you can create a new password. Or call Member Services for assistance during business hours, Monday through Friday.
This will happen if we don't have your current personal e-mail on file. If you have another e-mail address, you may want to check that inbox.
Of course, you cannot check or change your password without signing on. You'll need to call Member Services for assistance during business hours, Monday through Friday.
You have several options for paying bills. To pay online, you must be registered with Kaiser Permanente member website and sign on. Go to Medical Bills on your secure home page.Billing Statements and Payments
Kaiser Permanente's Patient Financial Services will generate a billing statement and send it to you. (You can opt out of receiving a paper bill by signing on, going to Medical Billing on your secure home page, and choosing paperless.)
If the account is not paid in full at the time of the first mailing, a second bill will be sent 30 days later. Subsequent bills will be sent every 30 days until the balance is paid in full. Unless the account is in dispute, the bill will be turned over to a collection agency after four mailings. If you have difficulty paying a bill, you can request financial assistance.Billing Statements and Payments
Updating E-mail, Information
You can order a new ID card online if you are registered and signed on to the Kaiser Permanente member website. Or call Member Services during business hours. You will receive a new card in the mail in approximately 10 business days.
Meanwhile, you can still receive medical care from your medical center if you need care.About Your Member ID Card