KP Plus
Getting Care
Choose your doctor and change anytime.
Getting connected with a Kaiser Permanente primary care provider who suits your individual needs is the first priority. Choose from a wide range of great providers or stay with your current provider. And remember—you can change your Kaiser Permanente PCP at any time. Your plan provides you with that flexibility.
Here’s an overview of getting care with KP Plus. You have the option to see Kaiser Permanente providers in California, or any other licensed provider in the country.
Kaiser Permanente Providers in California
Many ways to access care through the Kaiser Permanente care delivery system
- Kaiser Permanente has convenient locations within our service area in California.
- Kaiser Permanente providers offer coordinated care with the lowest out-of-pocket costs for office visits and pharmacy.
- Save time and trips with doctors, pharmacy, labs, and X-rays all under one roof at most locations.
- Access quality care from wherever you are. Chat online with a clinician, email your doctor, complete an e-visit, or schedule a phone or video visit. Learn more at kp.org/getcare.1
- Members can also use kp.org and our mobile app to schedule certain appointments, email their doctors, view lab results, and refill prescriptions online.2
- To find a Kaiser Permanente provider in California, search the Kaiser Permanente Provider Directory:
Kaiser Permanente Providers and Locations – Northern California
Kaiser Permanente Providers and Locations – Southern California
- When appropriate and available. These features are available when you get care at Kaiser Permanente facilities. For high deductible health plan members, phone and video appointments are subject to your plan’s annual deductible. If you travel out of state, phone appointments and video visits may not be available due to state laws that may prevent doctors from providing care across state lines. Laws differ by state. To have a video visit, members must be registered on kp.org and have a camera-equipped computer or mobile device. Applicable cost shares will apply for services or items ordered during an e-visit.
- To use the Kaiser Permanente app, you must be a Kaiser Permanente member registered on kp.org.
Out-of-Network Providers
Any other licensed provider or physician in the country
Call any licensed provider anywhere directly for care
- Your out-of-network benefit covers care you receive from any licensed provider (who’s not in the Kaiser Permanente California care delivery system) for up to 10 physician visits or covered outpatient medical services, including 5 prescription fills or refills each year.
- You don’t need a referral or prior authorization to use the out-of-network benefit.
- You may also pay a higher cost share for procedures performed in the out-of-network provider’s office (such as drugs administered during an office visit).
- You may be responsible for any amount billed that is above the amount your plan covers. You may be asked to pay the full cost of the visit up front and submit a claim for reimbursement.
- Please see the Claims section to learn about filing a claim after seeing an out-of-network provider.
Helpful Tips
- When making an appointment. Make sure the out-of-network provider understands that your plan provides coverage to see any licensed provider for certain covered outpatient services.
- Download or print the KP Plus Information for Out-of-Network Providers and bring it to your appointment. The information will be helpful for out-of-network providers and their staff.
- When checking in for your visit. Bring your Kaiser Permanente ID card with you. If the out-of-network provider has any questions, have them call the customer service center phone number on the back of your ID card.
- After your visit. When you receive services from an out-of-network provider, you may need to submit a claim and will be responsible for paying the difference, if any, between what is billed and what your plan covers.
- You’ll generally pay higher out-of-pocket costs when you receive services from an out-of-network provider or facility.
To make the most of your visits:
- To make the most of your out-of-network services, you may want to save them for office visits with an out-of-network provider. You can do this by using Kaiser Permanente providers for labs, imaging, and other procedures. That way, they’re covered by your in-network benefit, rather than your out-of-network benefit. We can send lab results to your out-of-network provider.
To find out more:
- Refer to your Evidence of Coverage (EOC) or contact the human resources/benefits officer where you work for a copy of your EOC.
- Refer to your ID card or call Customer Service, Monday through Friday, 7 a.m. to 7 p.m. Pacific Time at 1-800-788-0710 (TTY 711).