OE Self Guided PowerPoint Presentation 2019 - Full Version ...

County of San

Bernardino-Retirees

2019 Open Enrollment

Presentation for

Healthy togetherCare and coverage that fits your life

Copyright ©2018 Kaiser Permanente.

Quality care with you at the center

Our physician-led care teams work together to

keep you healthy by delivering high-quality,

personalized care. You can expect:

Kaiser Permanente See how our care and coverage can help you thrive

Great care from great doctors

Better care with a connected team

Personalized care for all members


Schedule

appointments

and get 24/7

medical advice

by phone.

Meet face to

face with your

doctor online.*

Email your

doctor’s office

anytime.

Visit your

doctor at your

local facility.

Your care, your way

Save yourself a

trip to the

doctor’s office

with a telephone

appointment.*

*Where available and for certain medical conditions.



Care away from home

*This number can be dialed from both inside and outside the U.S. Outside, you must dial the U.S. country code 001 for landlines and +1 for mobile before the

phone number. Long-distance charges may apply and we cannot accept collect calls. Phone line is closed major holidays (New Year’s Day, Easter, Memorial

Day, July Fourth, Labor Day, Thanksgiving, and Christmas), and closes early the day before a holiday at 10 p.m. Pacific time (PT). The phone line reopens the

day after a holiday at 4 a.m. PT.

• If you get hurt or sick while traveling, we’ll help

you get care. All our plans include emergency

and urgent care coverage from qualified

providers anywhere in the world.

• We can also help you before you leave town by

checking to see if you need a vaccination,

refilling eligible prescriptions, and more. Just

call us or go online:


24/7 Away from

Home Travel Line:

951-268-3900*

kp.org/travel



Care and coverage built around you

What’s integrated care?

A simpler, seamless experience where

the health plan and doctors work

together for you.

You get:

• Hassle-free health care with less

paperwork

• A care team that’s connected to each

other and you

• Many services under one roof


World-class specialty care


thrive.kp.org/healthier-outcomes

Maternity care

From family

planning to first

steps, and beyond.

kp.org/maternity

Mental health

and wellness

Our members can access

mental health services

with no referral needed.

kp.org/mentalhealth

Cardiac care

Healing hearts and

saving lives with

advanced cardiac care.

kp.org/cardiaccare

Photo Photo Photo

No matter what life throws your way

When you need care the most, you can count on us. Get access to excellent

care from top-notch doctors across a wide range of specialties to keep you at

your best, including:


Healthy resources

1Classes vary at each location and some may require a fee.2Not available in all areas.

• Personal wellness coaching

• Healthy lifestyle programs

• On-site health education classes

and support groups1

• Online videos, podcasts, recipes,

and more

• Reduced rates on health products

and services (for example, gym

memberships)

• Seasonal farmers markets2



Reach your health goals with wellness support

• 80% became more physically active

• 80% ate healthier

• 79% reduced their stress

• 65% quit tobacco

• 64% achieved or maintained a

healthy weight


• Acupuncture

• Chiropractic care

• Gym memberships

• Massage therapy

• And more

Source: Kaiser Permanente internal data.

Wellness coaching

We’ve helped thousands of

members reach their health goals.

After 2 or more phone sessions

with a coach:

Member discount programs

We offer special discounts on health-

related products and services to

members. Discount programs vary

by region, and can include:


Manage your care anytime, anywhere

At kp.org or with the Kaiser Permanente app, you can stay on top of your care 24/7:1

• Schedule and cancel routine

appointments

• Refill most prescriptions

• Choose your doctor and

change anytime

• View most lab test results

• Email your doctor’s office

with nonurgent questions

• Manage your coverage

and estimate costs2

• View and pay bills

• Manage a family member’s

health care3 1Available when you get care at Kaiser Permanente facilities.2These tools are not yet available on smartphones and tablets.3Due to privacy laws, certain features may not be available when they are being accessed on behalf of a child 18 or younger,

and your child’s physician may be prevented from disclosing certain information to you without your child’s consent.



Ready for an easy switch?

There’s a lot to do when you’re changing health plans. That’s why Kaiser Permanente offers a single,

online destination that shows how easy it is to:

Choose your new doctor.


Learn more at kp.org/easyswitch.

Seamlessly transfer your care

and prescriptions.

Get care on your schedule.


kp.org/newmember

welcome site

ID card and

quick guide to

getting started

Personalized

welcome bookWelcome call

Welcome letter from

primary care doctor

Anytime Within 1 to 10 days of your start date After you choose a doctor

What new members can expect



Yearly deductible $ 0 individual / 0 family

Maximum yearly out-of-pocket costs $1,500 individual / 3,000 family

Covered service You pay

Preventive care $ 0 copay

Doctor’s office visit $10 copay

Lab tests and radiology $0 copay

Outpatient surgery $10

Hospitalization $ 0

Emergency care $ 50

Prescribed medications (100-day

supply)

$10 copay (generic medication) / $15 copay (brand name

medication) /$15 copay 30 day supply(specialty medication)*

Traditional HMO Plan – High Option

Pre-65 RetireesThis table shows some benefits of your group and is provided as an example only:

*This is a summary of some benefits and their copays and coinsurance. For specific information about your covered health plan benefits, limitations, and

exclusions, including those not listed in this summary, please see your Evidence of Coverage.






Preventive care $ 0 copay ( routine physical exams)



Outpatient surgery $10 per procedure

Hospitalization $ 0

Emergency care $ 50


supply)

$10 copay (generic medication) / $20 copay (brand name

medication) / 20% coinsurance(not to exceed $100) 100 day

supply(specialty medication)*

Traditional HMO Plan - High Option

Post-65 Retirees (KPSA)This table shows some benefits of your group and is provided as an example only:





Yearly deductible $500 individual / 1,000 family

Maximum yearly out-of-pocket costs $3, 000 individual / 6,000 family


Preventive care $0 copay


Lab tests and radiology $10 copay /after plan deductible

Outpatient surgery 20% coinsurance*after plan deductible

Hospitalization 20% coinsurance* after plan deductible

Emergency care 20% coinsurance* after plan deductible


supply)

$10 copay (generic medication) / $30 copay after plan

deductible (brand name medication) / $30 copay -30 day

supply after plan deductible (specialty medication)*

Deductible HMO Plan – Low Option

Pre-65 RetireesThis table shows some benefits of your group and is provided as an example only:








Preventive care $ 0 copay

Doctor’s office visit $ 25 copay


Outpatient surgery $ 25 per procedure

Hospitalization $ 500 per admission

Emergency care $ 50

Prescribed medications (30-day supply) $10 copay (generic medication) / $25 copay (brand name

medication) / 20% coinsurance(not to exceed $100) 100 day

supply(specialty medication)*

Traditional HMO Plan – Low Option

Post-65 Retirees (KPSA)This table shows some benefits of your group and is provided as an example only:





Map not to scale

Southern California


15 medical centers

119 medical offices

10 affiliated plan hospitals

4 affiliated medical offices

N


Southern California new locations


San Diego Medical Center

Viewridge Medical Offices

Open now

• Baldwin Hills–Crenshaw Medical Offices

• Chino Grand Medical Offices

• La Habra Medical Offices

• Murrieta Medical Offices

• San Diego Medical Center

• Santa Clarita Medical Offices 2

• Ventura Market Street Medical Offices

• Viewridge Medical Offices

Coming soon

• Porter Ranch Medical Offices*

*Scheduled to open in 2018.


Thank you

OE Self Guided PowerPoint Presentation 2019 - Full Version ...

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