Washington Medicare Travel Benefits
Kaiser Permanente Washington members enrolled in select Medicare Advantage plans are covered for nonemergency routine medical care anywhere in the United States. To check and see what plan you have and if your plan includes Nationwide Visitor Travel, visit your kp.org member account. Check your Evidence of Coverage (EOC), Summary of Benefits, or call Member Services toll-free at 1-888-901-4600 (TTY 711), 8 a.m. to 8 p.m., 7 days a week for assistance.
Please note: You may need prior authorization from Kaiser Permanente Washington, depending on the services you are seeking while traveling. Reference chapter four of your Evidence of Coverage (EOC) to find out what services your plan covers and what services require a prior authorization or contact Kaiser Permanente Member Services. The same prior authorization and referral requirements apply while in and out of area. (An electronic copy of your EOC can be accessed in your member account for reference purposes.)
Call Member Services toll-free at 1-206-630-4600 or 1-888-901-4600 (TTY 711), 8 a.m. to 8 p.m., 7 days a week to confirm that your Kaiser Permanente Medicare Advantage (HMO) plan includes National Visitor Travel.
With National Visitor Travel, you are covered for routine care with any out-of-state provider who accepts Medicare outside of Kaiser Permanente’s operating states of Washington, California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, and Washington, D.C. However, if your provider is not a part of the MultiPlan or Banner (Arizona) provider networks, and you continue to see them, they will bill you directly. If this happens, send us a member reimbursement form once the bill has been paid. If you choose to change your provider, you have options. Before traveling, look for a provider near your destination who is a part of the MultiPlan network by searching in the online provider directory.
No, our partnership with MultiPlan just enhances our out-of-state travel benefit. You are still able to see any Medicare-participating provider outside of Washington, California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, and Washington, D.C. at in-network costs. To find Medicare-participating providers, visit medicare.gov/care-compare.
In advance of traveling, we recommend refilling all maintenance medications to avoid having to obtain a refill out-of-area. In the event you need a medication while out-of-area, you can have your prescriptions shipped to your location. All Kaiser Permanente Medicare Advantage (HMO) members with a prescription drug benefit have access to Kaiser Permanente mail-order drugs with nationwide shipping. If you must use an out-of-network retail pharmacy within the United States, you will generally have to pay the full cost (rather than your normal cost share) at the time you fill your prescription. You can ask to be reimbursed for a share of the 30-day supply cost by completing the Member Reimbursement Drug Claim Form.
Yes, all supplemental benefits included in your Medicare Advantage plan are covered nationwide and will be available to you as you travel. If you require assistance in accessing your benefits, call Member Services.
You may need prior authorization depending on the services you are seeking while traveling. Reference chapter four of your Evidence of Coverage (EOC) to find out what services your plan covers and what services require a prior authorization or contact Kaiser Permanente Member Services at the phone number on the back of your member ID card. The same prior authorization and referral requirements apply while in and out of area. (An electronic copy of your EOC can be accessed in your member account for reference purposes.) To seek prior authorization, call Member Services toll-free at 1-206-630-4600 or 1-888-901-4600 (TTY 711), 8 a.m. to 8 p.m., 7 days a week.