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PPO Plan

Finding Doctors and Facilities

Having a PPO plan makes it easy to find doctors and facilities for your care. You can switch between provider tiers as you desire.

With the PPO plan, you have two tiers of care to choose from: Participating Provider Tier or Non-Participating Provider Tier.

Participating Providers

  • Through the Participating Provider Tier, you can work directly with providers nationwide.
  • To find a Participating Provider or confirm if your current provider is part of the Participating Provider Tier, you can search for Providers by Location:

Kaiser Permanente States:  The PHCS Network provides access to care in the Kaiser Permanente states of CA, CO, GA, HI, MD, OR, VA, WA and DC.

Non-Kaiser Permanente States:  The CignaPPONetwork* only provides access to care in non-Kaiser Permanente states.

*Disclaimer:  The Cigna PPO Network refers to the health care providers (doctors, hospitals, specialists) contracted as part of the Cigna PPO for Shared Administration

  • After your initial search by type and location, you can then filter the search with several options including those who offer Telemedicine Services (another term for Telehealth) for appointments via methods such as telephone, video, or email.
  • No referral is needed to see a specialist. However, you will need precertification for some services and procedures if using the PHCS Network in California or other Kaiser Permanente states.  You are responsible for obtaining precertification. You must call 1-888-251-7052 (TTY 711) Monday through Friday, 6 a.m. to 6 p.m. Pacific Time for precertification.  If using the Cigna PPO Network for care in non-Kaiser Permanente states, the Cigna PPO providers are responsible for obtaining precertification on your behalf when precertification is required. You won’t be financially responsible if a Cigna PPO provider fails to obtain precertification for covered services.
  • Provide the Preparing for your Appointment document to your provider. This helps identify you as a Kaiser Permanente PPO Plan member with access to care through the PHCS Network for KPIC. It also gives the provider’s office important information about filing claims on your behalf.

Can I nominate a physician to become a Participating Provider?

  • Yes. If you were seeing a doctor who is not a member of either the PHCS Network for KPIC within California or other Kaiser Permanente States (CO, GA, HI, MD, OR, VA, WA and DC) or the Cigna PPO Network outside of the Kaiser Permanente States before you became a PPO member, you can nominate that doctor to join our network.  Please keep in mind your provider may choose not to be contracted.
  • To nominate a PHCS provider in CA or other Kaiser Permanente states, visit multiplan.com/kaiser.  To nominate a Cigna PPO Network provider outside of Kaiser Permanente states, call Customer Service at 1-800-788-0710 (TTY 711), Monday through Friday 7a.m. to 7p.m., Pacific time.
  • Review can take up to six months. Whether a physician or practitioner is accepted depends on several considerations, including the provider’s interest in joining, so a nomination doesn’t guarantee acceptance.

Non-Participating Providers

Choose any licensed provider anywhere for care.

  • Through the Non-Participating Provider Tier, you can work directly with any licensed provider or facility anywhere. Call the provider or facility directly for an appointment.
  • No referral is needed to 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.
  • Provide the Preparing for your Appointment document to your provider. This helps identify you as a Kaiser Permanente PPO 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.
  • Services covered under this tier generally have the highest out-of-pocket costs.