Provider and Care Options:
As a Level Funded Dual Choice PPO Member, you have multiple options for providers:
- Option 1: Kaiser Permanente Network of Providers
- Option 2: Participating Providers from the PHCS Network*
- Option 3: Any Other Licensed Provider in the US
Starting 01/01/2023 Provider Options 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 providers (doctors, hospitals, specialists) contracted as part of the Cigna PPO Network for Shared Administration.
To find a provider with Options 1 and 2, log into kp.org (*our PHCS network is customized so use kp.org for providers). For Option 3, you may reach out to providers directly, for services (view Plan Documents for covered services).
Your cost share will vary depending on each (with Options 1 and 2 having lower cost shares), as can be found in your plan’s “Summary of Benefits and Coverage” document below (find your specific plan name on your provided Plan Documents).
To learn more about costs estimates for medical services when selecting our Kaiser Permanente network of providers (Option 1 above):
a. before your effective date, please visit the Kaiser Permanente 2022 Sample Fee List.
b. after your effective date, please see the Cost Estimation Tool for Medical Services.
Pharmacy Options:
Level Funded Dual Choice PPO members, can fill a prescription written by any licensed provider at a KP Pharmacy, select OptumRx Pharmacies, or any licensed pharmacy (please note cost shares differ per selection).
To locate a pharmacy, log on to kp.org.
To see your formulary, or a list of covered drugs, open the kp.org Health & Wellness - Drug Formulary (Covered Drugs) page and select the PPO formulary: "Georgia Level Funded PPO Formulary".
To learn about pharmacy costs when using a Kaiser Pharmacy after your plan's effective date, please visit Pharmacy Services.
Care While Traveling:
Members who are traveling away from home, can plan ahead by visiting our Health Care Away from Home site. 24/7 care is available from Kaiser Permanente health care professionals by phone or video.
Forms & Plan Documents:
