Important Notice Regarding Coronavirus (COVID-19) and your Benefit Plan
Experience care your way. The OOA plan empowers you to choose how and where you get care.
Quick Documents and Links
Provider Directories
Drug Formulary
Formulary with Specialty Drug Tier – MedImpact Pharmacy (Non-grandfathered)
Standard Formulary – MedImpact Pharmacy (Grandfathered)
Claim forms
MedImpact Prescription Drug Claim Form
Other documents and forms
Walgreens Home Delivery Prescription Services
Walgreens Home Delivery Prescription Services en Espanol
Filling Prescriptions at MedImpact Retail Pharmacies
Filling Prescriptions at MedImpact Retail Pharmacies, en Espanol
MedImpact Standard Commercial Guidelines
Permanente Advantage – Precertification and Care Management
Permanente Advantage – Precertification and Care Management, en Espanol
Permanente Advantage Precertification Request Form
Member Care Transition Form, en Espanol
Preparing for your Appointment
Preparing for your Appointment, en Espanol
Confidential Communication Request Form (English)
Confidential Communication Revocation Form (English)
Your Rights and Protection Against Surprise Medical Bills
Understanding Your Plan and Benefits
Learn about the features and benefits of the Out-of-Area Indemnity (OOA) Plan.
How to Access Covered Care
Learn how to get care with providers.
Finding Doctors and Facilities
You can choose your provider and where to get care.
Pharmacy
Where and how to fill prescriptions.
Precertification
An overview of precertification and how to obtain it.
Member Support
Where and how to get member support.
Claims
When you need to file a claim and how to submit one to Kaiser Permanente Insurance Company.
Coverage Documents
Need a coverage document?
Documents and Forms
View, download, or print commonly used forms, FAQs, and other documents here.