Understanding Your Plan and Benefits
Dual Choice PPO allows you to make the best health care choice for you—wherever you are, and whenever you need care.
Here’s an overview of getting care with Dual Choice PPO. You have the option to see Kaiser Permanente Providers in Georgia, Network Providers, or any licensed provider.
In-Network Providers
Kaiser Permanente Providers in Georgia & Network Providers
In Georgia: Find Network Providers and Locations
In another Kaiser Permanente State: The PHCS Network provides access to care in the Kaiser Permanente states of CA, CO, HI, MD, OR, VA, WA, and DC.
Non-Kaiser Permanente States: The Cigna HealthcareSM PPO Network* only provides access to care in non-Kaiser Permanente states.
*Disclaimer: The Cigna PPO Network refers to the health care providers (doctors, hospitals, specialists) contracted as part of the Cigna PPO for Shared Administration.
Find Kaiser Permanente Pharmacies in Georgia
Hospital Surprise Billing Rating
Kaiser Permanente Providers in Georgia
Features and benefits of your insurance plan.
- Lowest out-of-pocket costs. With Kaiser Permanente Providers in Georgia, you’ll usually pay the lowest out-of-pocket costs for office visits and pharmacy copayments.
- Coordinated care. Your Kaiser Permanente Provider in Georgia works closely with specialists, pharmacists, lab technicians, therapists, and many other professionals. And because they are all connected through your electronic medical record, everyone in the Kaiser Permanente network gets up-to-the-minute information on your health for a better care experience. Coordinated care is with Kaiser Permanente Providers in Georgia only.
- Medical offices. Kaiser Permanente’s medical offices are located throughout the Georgia region with doctors, specialists, imaging, and in most locations, pharmacy and lab, all in one place.
- Emergency care. You are covered for emergency care worldwide. The emergency care copay will be waived if you are directly admitted to a hospital as a result of an emergency.
- Urgent care. Urgent care is available at Kaiser Permanente medical offices in Georgia. Call the number on the front of your ID card to confirm locations and hours of operations.
- Medical advice. When you call for medical advice, you will be connected with a professional that can help advise and make appointments with one of our providers. You can get advice by calling the number on the back of your ID Card, 24/7.
- Lab services. Your results from tests done in Kaiser Permanente medical offices in Georgia can be read (for most results) online soon after the lab completes your tests, sometimes the same day.
- No-cost preventive care. With your insurance plan, you pay $0 for preventive care. That includes routine physicals, well-child visits, and certain screenings and tests (such as mammograms).
- Choose from telehealth options that fit into your schedule. Chat with a Kaiser Permanente doctor in Georgia, email, or schedule a phone or video visit. Be aware that costs may apply for some visits.*
- Manage your health online. Use the convenient features of kp.org to manage your health.*
- Email your doctor’s office
- View most test results
- Schedule or cancel routine appointments
- Refill most prescriptions
- Register at kp.org/register
- Select your region
- Your user name and password can also be used on our mobile app
To find out more about what is covered with Kaiser Permanente Providers in Georgia, see your Certificate of Insurance (COI) or call Customer Service at 1-855-364-3185 (TTY 711), Monday through Friday, 8 a.m. to 6 p.m., Eastern time.
*Video visits are available for members who receive care at Kaiser Permanente medical offices in Georgia. You must be 18 or older to schedule a video visit. Check with your doctor’s office to find out if video visits are available to you.
Network Providers
Features and benefits of receiving covered care from our Network Providers.
With Network Providers, you don’t have to select a personal doctor. You can see any Network Provider without a referral.* To find up-to-date Network Providers or confirm if your current provider is part of the Network, you can search for Providers by Location, or call Customer Service at 1-855-364-3185 (TTY 711), Monday through Friday 8a.m. to 6p.m., Eastern time.
In Georgia: Find Network Providers and Locations
In another Kaiser Permanente State: The PHCS Network provides access to care in the Kaiser Permanente states of CA, CO, HI, MD, OR, VA, WA, and DC.
Non-Kaiser Permanente States: The Cigna HealthcareSM PPO Network* only provides access to care in non-Kaiser Permanente states.
*Disclaimer: The Cigna PPO Network refers to the health care providers (doctors, hospitals, specialists) contracted as part of the Cigna PPO for Shared Administration.
- PHCS Network for Kaiser Permanente Insurance Company. You can choose to receive your medical care through a provider contracted within the PHCS Network for Kaiser Permanente Insurance Company. PHCS is a subsidiary of MultiPlan, Inc.
- Cigna PPO Network. When getting care outside of a Kaiser Permanente state, you can choose to receive your care through a Cigna PPO Network provider.
- A wide network of contracted providers. Network Providers consist of doctors, hospitals, specialists, laboratories, and physical therapists across the country.
- Specialty care. You don’t need a referral for specialty appointments with any Network Providers. Cigna providers are responsible for all precertification. However, for Network Providers in the PHCS Network for KPIC, you must obtain precertification for certain services and treatments* such as:
- Inpatient hospital stay
- Outpatient surgery
- Home health, hospice, and skilled nursing facility services
- Imaging services
Please review your Certificate of Insurance (COI) for details
- Behavioral health. You can receive care for mental illness, emotional disorders, and drug or alcohol abuse from a Network Provider.*
- Hospital care. You can receive inpatient hospitalization services from Network hospitals and facilities. Your Network Provider may make arrangements for your hospital admission. (Important! Not all physicians contracted as Network Providers have admitting privileges with Network hospitals). Please confirm the hospital is contracted with the network or you may pay higher out-of-pocket costs.*
- Emergency care. You are covered for emergency care worldwide. The emergency care copay will be waived if you are directly admitted to a hospital as a result of an emergency.
- Urgent care. You can visit any licensed In-Network urgent care facility.
- Maternity care. You can choose a Network Provider for your obstetric care.*
- Lab tests, X-rays. You can contact facilities directly.
- No-cost preventive care. With your insurance plan, you pay $0 for preventive care. That includes routine physicals, well-child visits, and certain screenings and tests (such as mammograms).
- Pharmacy services. Learn about your pharmacy benefits with Network Providers.
To find out more about what is covered with Network Providers:
- Refer to your Certificate of Insurance (COI).
- Contact the human resources/benefits officer where you work, if your employer provides your coverage.
- Call Customer Service at 1-855-364-3185 (TTY 711), Monday through Friday 8 a.m. to 6 p.m., Eastern time, or refer to your ID card.
*Inpatient and certain outpatient services are subject to precertification, if using the PHCS Network in Georgia or other Kaiser Permanente states of CA, CO, HI, MD, OR, VA, WA and DC. You are responsible for obtaining precertification. You must call 1-855-265-0311 (TTY 711) for precertification. If using the Cigna PPO Network for care in non-Kaiser Permanente states, the Cigna PPO providers are responsible for obtaining precertification on your behalf when precertification is required. You won’t be financially responsible if a Cigna PPO provider fails to obtain precertification for covered services.
This site provides an overview of your benefits and services. If there are any differences between this document and your Certificate of Insurance (COI), your Certificate of Insurance (COI) will prevail.
For its Network Providers, Kaiser Permanente Insurance Company (KPIC) has contracted with PHCS, Inc., a subsidiary of MultiPlan, Inc. The list of participating PHCS Network for Kaiser Permanente Insurance Company providers is subject to change without notice.
The Cigna PPO Network refers to the health care providers (doctors, hospitals, specialists) contracted as part of the Cigna PPO for Shared Administration. Cigna is an independent company and not affiliated with Kaiser Foundation Health Plan, Inc., and its subsidiary health plans. Access to the Cigna PPO Network is available through Cigna’s contractual relationship with the Kaiser Permanente health plans.
The Cigna PPO Network is provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc.
Out-of-Network Providers
Any other licensed provider or physician
Features and benefits of receiving covered care from any licensed provider.
- Provider choice, care anywhere. Benefits cover care you receive from any licensed provider (who are not In-Network Providers).
- Using Out-of-Network Providers generally means higher out-of-pocket costs. Your out-of-pocket costs will generally be the highest when you choose to receive care from an Out-of-Network Provider or facility.
- Behavioral health. You can receive care from any licensed behavioral health or chemical dependency professional for mental illness, emotional disorders, and drug or alcohol abuse.*
- Hospital care. You can receive inpatient hospitalization services from licensed or accredited hospitals and facilities that are not associated with In-Network Providers.*
- Emergency care. You can visit any licensed Out-of-Network emergency care facility. Emergency care is covered at the In-Network provider benefit level, and you will be responsible only for the In-Network provider cost share, regardless of where you seek care.
- Urgent care. You can visit any licensed Out-of-Network urgent care facility.
- Maternity care. You can choose any licensed provider for obstetric care.*
- Lab tests, X-rays. You can contact facilities directly. You can request your Out-of-Network Provider send labs, X-rays, and special procedures (MRIs, CT scans, PET scans, nuclear medicine) to a Kaiser Permanente facility or a Kaiser Permanente Provider, any time you choose, and you will likely pay less.
- Pharmacy services. Learn about your pharmacy benefits with Out-of-Network Providers.
To find out more about what is covered with Out-of-Network Providers:
- Refer to your Certificate of Insurance (COI).
- Contact the human resources/benefits officer where you work, if your employer provides your coverage.
- Call Customer Service at 1-855-364-3185 (TTY 711), Monday through Friday, 8 a.m. to 6 p.m., Eastern time, or refer to your ID card.
*Inpatient and certain outpatient services are subject to precertification. You must call 1-855-265-0311 (TTY 711) for precertification.
This site provides an overview of your benefits and services. If there are any differences between this document and your Certificate of Insurance (COI), your Certificate of Insurance (COI) will prevail.