Forms & publications

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How to get health care when you travel

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Public Employees Benefits Board (PEBB) Program health plans have agreements with health providers at many destinations. This helps you get the medical care you may need. Contact your plan before you travel to find out about your options.

Publication

Kaiser Permanente NW Classic Certificate of Coverage (COC) 2019

This benefits book describes what is covered under Kaiser Permanente NW Classic, including medical services and prescription drugs, as well as specific services not covered by the plan. Finding preferred providers and how much you’ll pay, including deductibles, coinsurance, and copays. It also includes how to request an appeal, submit a claim, and how Medicare works with your plan.

Publication

Kaiser Permanente NW Classic Summary of Benefits and Coverage (SBC) 2019

A summary of what the Kaiser Permanente NW Classic plan covers and what it costs.

Publication

Kaiser Permanente NW Consumer-Directed Health Plan (CDHP) Certificate of Coverage (COC) 2019

This benefits book describes what is covered under Kaiser Permanente NW CDHP, including medical services and prescription drugs, as well as specific services not covered by the plan. Finding preferred providers and how much you’ll pay, including deductibles, coinsurance, and copays. It also includes how to request an appeal, submit a claim, and how Medicare works with your plan.

Publication

Kaiser Permanente NW Consumer-Directed Health Plan Summary of Benefits and Coverage (SBC) 2019

A summary of what the Kaiser Permanente NW Consumer-Directed Health Plan (CDHP) covers and what it costs.

Publication

Kaiser Permanente NW preauthorization requirements

Preauthorization requirements for Kaiser Permanente NW plans. Preauthorization is when you seek approval from your health plan for coverage of specific services, supplies, or drugs before receiving them. Some services or treatments (except emergencies) may require preauthorization before the plan pays for them. These criteria do not imply or guarantee approval. Please check with your plan to ensure coverage. Preauthorization requirements are only valid for the month published. They may have changed from previous months and may change in future months.

Publication

Kaiser Permanente NW Senior Advantage Certificate of Coverage (COC) 2019

This booklet gives you the details about your Medicare health care coverage from January 1 to December 31, 2019. This benefits book describes what is covered under Kaiser Permanente Senior Advantage, including medical services and prescription drugs, as well as specific services not covered by the plan. Finding preferred providers and how much you’ll pay, including deductibles, coinsurance, and copays. It also includes how to request an appeal, submit a claim, and how Medicare works with your plan.

Publication

Kaiser Permanente WA (formerly Group Health) Classic non-Medicare Retiree Certificate of Coverage (COC) 2018

This benefits book describes what is covered under Kaiser Permanente WA (formerly Group Health) Classic, including medical services and prescription drugs, as well as specific services not covered by the plan. Finding preferred providers and how much you’ll pay, including deductibles, coinsurance, and copays. It also includes how to request an appeal, submit a claim, and how Medicare works with your plan.

Publication

Kaiser Permanente WA Classic Certificate of Coverage (COC) 2019

This benefits book describes what is covered under Kaiser Permanente WA Classic, including medical services and prescription drugs, as well as specific services not covered by the plan. Finding preferred providers and how much you’ll pay, including deductibles, coinsurance, and copays. It also includes how to request an appeal, submit a claim, and how Medicare works with your plan.

Publication

Kaiser Permanente WA Classic Summary of Benefits and Coverage (SBC) 2019

A summary of what the Kaiser Permanente WA Classic plan covers and what it costs.

Publication

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