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HomeMy WebLinkAboutKaiser Away from Home Travel FAQKnow before you go Make sure you understand what services are covered. Check your Evidence of Coverage, Summary Plan Description, or Membership Agreement. Or call Member Services if you have any questions. Before your trip What should I do before my trip? • Register on kp.org so you can see your health information online and email your doctor anytime. • Get our Kaiser Permanente app to stay connected when you’re on the go. • See your doctor if you need to manage a condition during your trip. • Refill your eligible prescriptions to have enough while you’re away. • Print a summary of your online medical record in case you don’t have Internet access while you’re traveling. • Make sure your immunizations are up-to-date, including your yearly flu shot. • If you’re leaving the country, talk to your doctor or local Kaiser Permanente travel clinic about vaccinations or medications you may need. • Pack your Kaiser Permanente ID card. It has important phone numbers on the back. What services are covered? You’re covered for emergency and urgent care while traveling anywhere in the world.* If you’re traveling in another Kaiser Permanente or GHC area, you can also get most routine and specialty care as a visiting member. Just make sure it’s provided or referred by a Kaiser Permanente or GHC doctor in the area you’re visiting. Services available to visiting members are not the same in all areas. For example, some plans may not offer routine or specialty care for visiting members. For more information, call Member Services in your home area, or call the number on your Kaiser Permanente ID card. Kaiser Permanente areas You can get care in any of these Kaiser Permanente areas: parts of California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, Washington (southwest part of the state), and Washington, D.C. Find a Kaiser Permanente location near you at kp.org/kpfacilities. You can also get care through Group Health Cooperative (GHC), a nonprofit group that offers care to Kaiser Permanente members in east and northwest Washington, and in northern Idaho. For GHC locations, visit ghc.org/about_gh. What to do before, during, and after your trip Getting care away from home You never know what might come up when you’re away from home, so be prepared. Here are some answers to common questions to help you plan for a healthy trip. Visit kp.org/memberservices/numbers for the phone number in your area. Types of care Different health needs require different types of care. If you’re not sure what kind you need, call our advice nurses. Emergency care A medical or psychiatric condition, including severe pain, that requires immediate medical attention to prevent serious jeopardy to your health.* Examples include: • Chest pain or pressure that may move out to the arm, neck, back, shoulder, jaw, or wrist • Severe stomach pain that comes on suddenly • Severe shortness of breath Urgent care An illness or injury that requires prompt medical attention, but is not an emergency medical condition. Examples include: • Minor injuries, minor wounds, and cuts needing stitches • Minor breathing issues • Minor stomach pain Routine care An expected care need, like a scheduled visit to your doctor or a recommended preventive screening. Examples include: • Physical exams • Well-child checkups • Immunizations (shots) I’m a student and go to school away from home. Am I covered for care? Yes. You’re covered for emergency and urgent care anywhere in the world.* If you go to school in another Kaiser Permanente area, you can also get most routine and specialty care as a visiting member. If you go to school outside a Kaiser Permanente area, most plans only cover emergency and urgent care. We recommend you check with your school to see what you’re covered for while you’re away from home. Certain plans offer out-of-area student coverage.† If you’re in one of these plans, you may be able to get routine, nonurgent services if your school isn’t near a Kaiser Permanente facility. For more information, call Member Services. What if my normal prescription amount isn’t enough for my trip? You may be able to refill many prescriptions early or get more than usual. To ask for an early refill or an extra refill: • Talk to someone at a Kaiser Permanente pharmacy. Just call or visit one of our pharmacies near you. • If you need doctor approval, the pharmacy will contact your doctor. • Be sure to ask for your medication at least 1 week before your trip so there’s time to process your request. What costs should I expect? Since you’re covered for emergency and urgent care anywhere in the world,* you can ask for a reimbursement for this type of care when you pay for it out of pocket.‡ Just be sure to submit a claim for reimbursement once you get back home. See “After your trip” for details on filing a claim. If your plan covers routine and specialty care services when you visit another Kaiser Permanente area, you may still have to pay upfront when getting care. Your payments may be different from the copays, coinsurance, or deductible payments you have at home. To find out whether you’ll need to pay upfront for services, call Member Services. If you get emergency or urgent care while traveling in another country, you’ll need to pay the provider for the full cost of your care. Kaiser Permanente generally doesn’t pay providers outside the United States directly. Costs can be high, so be ready to cover any unexpected costs. For emergency or urgent care in the U.S., the provider may bill Kaiser Permanente directly. But you’ll still need to pay any copays, coinsurance, or deductibles that apply under your plan. Visit kp.org/memberservices/numbers for the phone number in your area. Reporting an emergency If you have a medical emergency, report it to Kaiser Permanente once your condition is stabilized. Call us at the post-stabilization care number listed on the next page. If you’re calling from outside the U.S.: • Check with the local telephone service provider where you are if you need help calling internationally. • International calls to this number aren’t toll free, and you’ll be charged at local international rates. Before leaving the U.S., make sure you’ll be able to call us. Find out if your cell phone service includes international calling, or get an international calling card. During your trip What should I do if I have a medical emergency? Immediately go to the nearest hospital or any facility that can give you the care you need.* In the U.S., you can also call 911. Always use the emergency services available where you are. You don’t have to get approval first to get emergency or urgent care. If you get care from a non–Kaiser Permanente provider, call us once your condition is stable to let us know you’ve received emergency care or been admitted to a hospital. If appropriate, the doctor treating you can call instead. If you’ve been hospitalized and need post-stabilization care, you’ll need approval first. Your call starts this process and helps protect you financially. What if I have an urgent medical condition that isn’t an emergency? If you’re outside a Kaiser Permanente area and are in the United States, you can visit an urgent care clinic instead of a hospital emergency department. If you’re not sure whether you need urgent care, you can call us for advice. We’ll help you figure out what type of care is right for you. Just call the appointment and advice line in your home area. If you’re outside the U.S., go to the nearest hospital or any facility that can give you the care you need. We’ll cover urgent care at non–Kaiser Permanente facilities anywhere in the world as long as it can’t wait until you get back home. How do I see a doctor when I’m in another Kaiser Permanente area? Call Member Services in the Kaiser Permanente area you’re in and tell them you’re a visiting member: • You’ll get a temporary medical record number (MRN) or health record number (HRN) and information for making an appointment. • You’ll only use your temporary MRN or HRN in the area you’re visiting. • When you get back home, you’ll use your home MRN or HRN to get care. What if I run out of my medication during my trip? If you’re in the United States, but not in a Kaiser Permanente area, you can get your medication refilled at a local pharmacy as long as you have refills left on your prescription. When you go to the pharmacy: • Bring your health record number or medical record number and your prescription information. • The pharmacy will call Kaiser Permanente to transfer your prescription.‡ • You’ll need to pay for the full cost of medication up front and file a claim for reimbursement when you get home. If you’re in a Kaiser Permanente area, call Member Services in that area: • We’ll help you find a pharmacy nearby. • Depending on your plan, you may need to pay for your medication up front and file a claim for reimbursement when you get home.‡ • You’ll also need to pay any copays, coinsurance, or deductible payments you would pay at home. Visit kp.org/memberservices/numbers for the phone number in your area. Member Services phone numbers Region Phone number Hours California 1-800-464-4000 1-800-777-1370 (TTY) Open 24 hours a day, 7 days a week (closed holidays) Colorado (Denver/Boulder) 303-338-3800 (from Denver metro area) 1-800-632-9700 (from other areas) 303-338-3820 (TTY, from Denver metro area) 1-800-521-4874 (TTY, from other areas) Mon–Fri, 8 a.m.–5 p.m. Northern Colorado (including Loveland, Greeley, and Fort Collins) 1-800-632-9700 1-800-521-4874 (TTY) Mon–Fri, 8 a.m.–5 p.m. Southern Colorado (including Colorado Springs, Pueblo, and Cañon City metro areas) 1-888-681-7878 1-800-521-4874 (TTY) Mon–Fri, 8 a.m.–5 p.m. District of Columbia 301-468-6000 (from D.C. metro area) 1-800-777-7902 (from other areas) 301-879-6380 (TTY) Mon–Fri, 7:30 a.m.–5:30 p.m. Georgia (Atlanta metro area) 404-261-2590 (from Atlanta metro area) 1-888-865-5813 (from other areas) 1-800-255-0056 (TTY) Mon–Fri, 7 a.m.–7 p.m. Hawaii (Islands of Oahu, Maui, Hawaii, Kauai, Lanai, and Molokai) 808-432-5955 (from Oahu) 1-800-966-5955 (from other areas) 1-877-447-5990 (TTY) Mon–Fri, 8 a.m.–5 p.m.; Sat, 8 a.m.–noon Maryland (Baltimore and suburban D.C. area) 301-468-6000 (from D.C. metro area) 1-800-777-7902 (from other areas) 301-879-6380 (TTY) Mon–Fri, 7:30 a.m.–5:30 p.m. Oregon/southwest Washington 503-813-2000 (from Portland) 1-800-813-2000 (from other areas) 711 (TTY) 1-800-324-8010 (language interpreter) Mon–Fri, 8 a.m.–6 p.m. Virginia (Northern area) 1-800-777-7902 301-879-6380 (TTY) Mon–Fri, 7:30 a.m.–5:30 p.m. Phone numbers for reporting an emergency (or post-stabilization care) Region Phone number Hours California 1-800-225-8883 7 days, 24 hours a day Colorado (Denver/Boulder)303-338-3800 Mon–Fri, 8 a.m.–5 p.m. Colorado (Sr. Advantage Members)1-800-476-2167 7 days a week, 8 a.m.–8 p.m. Northern Colorado 1-800-632-9700 Mon–Fri, 8 a.m.–5 p.m. Southern Colorado 1-888-681-7878 Mon–Fri, 8 a.m.–5 p.m. Hawaii 1-800-227-0482 Mon–Fri, 8:00 a.m.–4:30 p.m. Georgia 1-800-221-2412 7 days, 24 hours a day Maryland (Baltimore and suburban D.C. area) Virginia 1-800-777-7904 (advice line) 1-800-777-7902 (Member Services) 7 days, 24 hours a day Mon–Fri, 7:30 a.m.–9 p.m. (except holidays) Northwest 1-877-813-5993 7 days, 24 hours a day TTY 711 After your trip I paid for care during my trip. How do I get reimbursed? If you paid for emergency or urgent care while away from home, you’ll need to file a claim for reimbursement.‡ You’ll also need to give us: • An itemized bill or other documentation for services • A copy of medical records for the services you received • Proof of payment If you got care outside the U.S., you’ll also need to show proof of travel, like travel tickets, boarding passes, and a copy of passport stamps. Make sure to keep all these documents during your trip. When you get back home, you’ll need to fill out a claim form and mail it with the documentation above. For instructions on submitting a claim, call Member Services. For claim forms, go to kp.org/travel. Visit kp.org/travel for extra resources Our website offers more information on getting care when traveling. You’ll also find helpful resources like: • Travel brochures you can download and print • Claim forms in case you need to file a claim for reimbursement after your trip Services covered under your health plan are provided and/or arranged by Kaiser Permanente health plans: Kaiser Foundation Health Plan, Inc., in Northern and Southern California and Hawaii • Kaiser Foundation Health Plan of Colorado • Kaiser Foundation Health Plan of Georgia, Inc., Nine Piedmont Center, 3495 Piedmont Road NE, Atlanta, GA 30305, 404-364-7000 • Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc., in Maryland, Virginia, and Washington, D.C., 2101 E. Jefferson St., Rockville, MD 20852 • Kaiser Foundation Health Plan of the Northwest, 500 NE Multnomah St., Suite 100, Portland, OR 97232 • Services for self-insured plans are administered by Kaiser Permanente Insurance Company, One Kaiser Plaza, Oakland, CA 94612. Visit kp.org/memberservices/numbers for the phone number in your area. Please recycle. 60258914 May 2015 * If you reasonably believe you have an emergency medical condition, which is a medical or psychiatric condition that requires immediate medical attention to prevent serious jeopardy to your health, call 911 or go to the nearest emergency department. For the complete definition of an emergency medical condition, please refer to your Evidence of Coverage (EOC), Certificate of Insurance, or Summary Plan Description (SPD). † This coverage may be available to dependent students who permanently live in Colorado, Hawaii, Oregon, or Washington state, but are temporarily moving out of the area for school. Call Member Services for more information. ‡ The amount members are reimbursed will depend on what their copays or coinsurance are, whether they have a deductible, and other plan limitations.