Kaiser

This Kaiser-administered plan allows you to choose any health care provider within a single statewide networkNetworkThe facilities, providers and suppliers with whom your health insurer or plan has contracted to provide health care services. It is recommended that you select a Primary Care PhysicianPrimary Care Provider (PCP)A physician (medical doctor or doctor of osteopathic medicine), nurse practitioner, clinical nurse specialist or physician assistant, as allowed under state law, who provides, coordinates or helps a patient access a range of health care services to direct your care. In most cases, referralsReferralA written order from your primary care provider for you to see a specialist or receive certain health care services for any covered service that cannot be performed by your primary care provider. This applies to our Anthem Exclusive and Kaiser plans.   are required but you may self-refer to certain specialists.

In place of a deductible, you will be responsible for a copayCopayment (copay)A fixed-dollar amount that you must pay out of your pocket at the time of service to a provider or a facility for a specific health covered service.  Copays do not apply to the deductible requirement. For example, an office visit may have a copay of $30 under the Exclusive Plan and $40 under the Extended.  You must pay the amount at the time of service. for medical visits, diagnostic testing and hospital/facilities services. Out-of-networkOut-of-NetworkNon-participating providers or facilities that do not enter into a network agreement, usually resulting in higher out of pocket expenses to you. care is not covered except for emergency and urgent care.