Out-of-Area Indemnity Plan
How to Access Covered Care
Choose your doctor and change anytime.
Getting in-depth information on how your plan works and getting connected with a provider who suits your individual needs is the first priority.
In the Out-of-Area Indemnity (OOA) Plan, you can get care from any licensed provider, hospital, or laboratory of your choice. Or, you can stay with the personal physician you already know and trust.
For members who have a POS, Out-of-Area PPO, or PPO plan – For Information about Kaiser Permanente Insurance Company’s (KPIC’s) Network Adequacy Policy, please review our Frequently Asked Questions Document
Call any licensed provider’s office directly.
- Your health insurance plan covers you for care you receive from any licensed provider near your home or your work.
- You can call the provider’s office directly to make an appointment.
- No referral is needed when you see a specialist. However, you will need precertification for some services and procedures. You must call 1-888-251-7052 (TTY 711), Monday through Friday, 6 a.m. to 6 p.m., Pacific time, for precertification.
- Your doctor may require you to pay the full cost of the visit. You may need to submit a Medical Claim Form and itemized bills for reimbursement.
- You’ll have to pay coinsurance and meet a deductible. You’ll also be responsible for any difference between what your provider charges for service and the payment Kaiser Permanente Insurance Company provides.
- Kaiser Permanente Providers and Hospitals are not contracted under the Out-of-Area Indemnity (OOA) plan and would be considered and processed under the non-participating provider tier.
Helpful Tips
- When making an appointment. Make sure the provider understands that your plan allows you to see any licensed provider.
- Preparing for your Appointment
- When checking in for your visit. Bring your ID card with you. If your provider has any questions, have them call the customer service phone number on your ID card.
- Provide the Preparing for your Appointment document to your provider. This helps identify you as a OOA Plan member with access to care to any licensed provider. It also gives the provider’s office important information about filing claims on your behalf.
To find out more:
- See your OOA Member Handbook has details about accessing covered care.
- Refer to your Certificate of Insurance (COI).
- Contact the human resources/benefits officer where you work if your employer provides your coverage.
- Call Customer Service at 1-800-788-0710 (TTY 711), Monday through Friday, 7 a.m. to 7 p.m., Pacific time, or refer to your ID card.
The Out-of-Area Indemnity (OOA) Plan is underwritten by Kaiser Permanente Insurance Company (KPIC), a subsidiary of Kaiser Foundation Health Plan, Inc. Some services require precertification.