When you visit a Kaiser pharmacy, you’ll need two cards:

• Kaiser ID card tells your Kaiser provider what benefits coverage you have – including prescriptions
• Kaiser Visa Health Payment Card Visa Debit Card is loaded with your Health Account credits and — if you elected the Health Care FSA — your annual FSA contribution

You and your family members each get four free visits a year to a primary care doctor:

• General or family practitioners
• Doctors of internal medicine
• Pediatricians
• Family nurse practitioners
• OB/GYNs
• Non-hospital urgent care facilities

Urgent Care

An urgent care need is one that requires prompt medical attention, but is not an emergency medical condition.* If you have an illness or injury that’s not life- or limb-threatening, but also can’t wait, Kaiser’s urgent care departments can help.

Urgent care is covered as primary care, so you won’t have to pay a deductible. After you’ve used your four free primary care visits for the year, you pay 10% of the cost.

For Kaiser members, urgent care is located in many of Kaiser’s Northern California facilities. Note: If you go to a Kaiser medical office without a hospital, it’s likely to be billed as an emergency, not as urgent care.

If you’re not sure what kind of care you need, Kaiser’s advice nurses can direct you to the most appropriate place for treatment and provide advice, when medically necessary. Call Kaiser Member Services at 1-800-663-1771 for more information.

*If you reasonably believe you have an emergency medical condition, which is a medical or psychiatric condition that requires immediate medical attention, call 911.

Emergency Care

You pay 20% of the cost, subject to the annual deductible. After you visit the emergency room, your HAP plan administrator — Kaiser — will process the claim and then send you an Explanation of Benefits (EOB).

Kaiser provides all mental health and substance use disorder care for its members except inpatient and residential substance use disorder treatment which is covered by Carelon Behavioral Health. To preauthorize care, contact Kaiser at 1-877-750-3399 or Carelon at 1-888-445-4436.

Here’s what you pay for services:

• Outpatient services: You pay 10% of the cost with no deductible
• Inpatient services: You pay 20% of the cost after you meet the annual deductible

Visit kp.org/mentalhealth for resources on the following:

• How to connect to care
• What to expect
• Understanding your health plan benefits (need KP member number to access)

Finding a Counselor or Psychiatrist

Reach out to Kaiser at 1-800-390-3503 for a list of in-network referrals. Usually, Kaiser will select a provider for you, but you also have the option to go to kp.org > Doctors & Locations and search for your own. View helpful hints on selecting a counselor who is a good fit for you.

Telehealth Alcohol Treatment

Ria Health, covered through the Kaiser HAP, is an innovative telehealth alcohol treatment program that uses medications, online counseling, and support to help you achieve lasting results. 

• Expert physician guidance, care, support, and customized treatment plans.
• Medications that reduce alcohol cravings, helping people quit or drink less.
• Withdrawal management.
• Weekly telehealth meetings with a certified recovery coach.
• Bluetooth-enabled breathalyzer and smartphone app to track progress.
• Regular online group support meetings facilitated by a recovery coach.

Get started by calling Ria Health at 1-877-343-5131 or online at riahealth.com/lp/pge.

Inpatient and Residential Substance Use Disorder Treatment

Carelon provides Kaiser members with inpatient and residential substance use disorder treatment. To preauthorize Carelon care, contact:

• A Carelon care manager 24/7 at 1-888-445-4436
• An onsite Employee Assistance Program Counselor during normal business hours

Detoxification services can be provided through Kaiser or Carelon.

Applied Behavior Analysis

Applied Behavior Analysis services can be provided through Kaiser or Carelon (at no charge, with no deductible). To obtain prior authorization or pre-certification from Carelon, please call 1-888-445-4436. During this call, a care manager will request basic information — including, but not limited to — a child’s diagnosis, who made the diagnosis, and what the presenting symptoms are (e.g., developmentally delayed skills, problem behaviors).

Mental Health and Wellness Tools

Take a moment. Take a breath. Take time for self-care. Explore Kaiser’s broad range of self-care resources and apps designed to help you thrive in mind, body, and spirit, including:

• The Calm app for meditation and sleep
• 24/7 access to emotional support coaches via text through Headspace Care 
• Classes and support groups
• Audio activities and articles
• Depression Awareness and Help
• And more

Visit Kaiser’s mental health and wellness tools website to get started.

In general, you must use doctors and facilities in the Kaiser Permanente California region to get benefits. However, emergencies can happen anywhere. As a Kaiser Permanente member, you’re covered for an emergency and urgent care anywhere in the world. Whether you’re traveling in the U.S. or a foreign country, the Emergency and Urgent Care Away from Home brochure explains what to do if you need emergency or urgent care during your trip.

Whether you’re planning a trip or already away from home, our travel line can help you:

• Find out how to fill an eligible prescription before you leave or while away from home.
• Find care in a Kaiser Permanente region.
• File a claim for reimbursement when you’re back.

Call the Kaiser Travel Line at 1-951-268-3900* for additional information.
*This number can be dialed from inside and outside the United States. Outside, you must dial the U.S. country code “001” for landlines and “+1” for mobile lines before the phone number. Long-distance charges may apply. This phone line is closed on major holidays.