Can I use California Kaiser Permanente out of state?

Answered by Tom Adger

As a Kaiser Permanente member, you can use your coverage for emergency and urgent care anywhere in the world, including outside of California. Whether you’re traveling within the United States or to a foreign country, Kaiser Permanente has you covered.

If you find yourself in need of emergency care while traveling, it’s important to know what steps to take to ensure you receive the appropriate care and that your expenses are covered. Here’s what you should do:

1. Assess the situation: Determine if the situation is a true emergency or if it can be addressed with urgent care. Emergency care is for life-threatening situations, such as severe injuries, chest pain, difficulty breathing, or loss of consciousness. Urgent care is for non-life-threatening conditions that require prompt attention, such as minor injuries, infections, or illnesses.

2. Call 911 or the local emergency number: If you’re experiencing a medical emergency, dial 911 or the local emergency number immediately. Explain your situation and provide your location. Emergency responders will be dispatched to assist you.

3. Seek care at the nearest facility: If you’re able to, go to the nearest hospital or emergency room for immediate care. If you’re in a foreign country and unsure where to go, ask for assistance from locals or contact your travel insurance provider for guidance.

4. Notify Kaiser Permanente: As soon as possible, contact Kaiser Permanente to inform them of your situation. They can provide guidance, answer any questions you may have, and help coordinate your care. Be sure to have your member ID and other relevant information on hand when contacting them.

5. Follow the recommended treatment: Once you receive care, follow the treatment plan recommended by the healthcare professionals. If you have any concerns or questions about the recommended treatment, don’t hesitate to discuss them with the healthcare provider.

6. Keep records and receipts: It’s important to keep copies of all medical records, bills, and receipts related to your emergency or urgent care. These documents may be necessary when filing a claim for reimbursement or coverage.

7. Contact Kaiser Permanente for reimbursement: After receiving care, contact Kaiser Permanente to inquire about the reimbursement process. They will provide you with the necessary forms and instructions to submit a claim. It’s important to do this promptly to ensure timely reimbursement.

It’s worth noting that while emergency and urgent care is covered by Kaiser Permanente anywhere in the world, routine or non-emergency care may have limitations or restrictions. It’s always a good idea to check with Kaiser Permanente before traveling to understand your coverage options and any pre-authorization requirements.

As a Kaiser Permanente member, you have coverage for emergency and urgent care worldwide. By following the steps outlined above and staying in contact with Kaiser Permanente, you can ensure you receive the necessary care and have a smooth reimbursement process.