shbp open enrollment booklet 2019€¦ · free to focus on living your life. and because good...

©2018 Kaiser Foundation Health Plan, Inc. 61057608 08/18

HEALTHIER FAMILY. HEALTHIER BUDGET. HEALTHIER YOU.

CHOOSEHEALTHIER CARE

2019 ENROLLMENT | GEORGIAmy.kp.org/shbp

SHBPState Health Benefit Plan

A Division of the Georgia Department of Community Health

Administered by

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Administered by

ARE YOU READY FOR BETTER CARE?Visit my.kp.org/shbp anytime

http://my.kp.org/shbp

Get great care and the resources you need to live healthier—all in one convenient package. Inside, check out everything that comes with your health plan.

Need more information?Call 855-512-5997 (TTY 711) Visit my.kp.org/shbp

» Simpler. Smarter. Healthier.Discover the difference of connected, affordable care.

» Unmatched convenience, virtually anywhereCall in, click in, or come in. In metro Atlanta or when traveling, we've got you covered.

» A network of skilled physicians500+ doctors, connected to each other, connected to you.

» Up to $1,000 per household in Wellness Rewards Earn reward cards when you take steps toward better health, supported by custom programs to help you thrive.

» No deductibles. Simple co-pays. No surprises.Our plan offers a simpler solution to advanced health care.

» Locations, locations, locations25 Kaiser Permanente medical offices + affiliated urgent care and trusted hospital partners throughout metro Atlanta. All in a network you can rely on.

THE TOTAL PACKAGE

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$0 DEDUCTIBLEAND UP TO $1,000in Wellness Rewards per household.

THE ONLY PLAN WITH A

Need care when traveling? We have you covered. Learn about all your

options for getting care on pages 7 - 9.

Kaiser Permanente

SIMPLE AND AFFORDABLE

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Our members can connect to doctors, lab, X-ray, and pharmacy under one roof—in person or online.

Our doctors are all connected by the largest commercial electronic health system in the country.

That means less traveling for you, less time waiting, and better coordination of your care.

SEE THE KAISER PERMANENTE DIFFERENCE

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CONVENIENT CARE THAT SAVES YOU TIME

Kaiser Permanente provides both your coverage and your care, meaning our top-ranked1 health plan and our top-notch medical care are fully integrated.

When your doctors, health plan, pharmacy, and hospitals are connected, health care works better for you, becoming more affordable and easier to use.

WHAT YOU NEED, ALL TOGETHER

When you get care in our facilities, your doctors, nurses, and other caregivers all work together to keep you healthy. They’re connected to each other, and to you, through your electronic health record. So they know important things about you and your health—like when you’re due for a screening and what

medications you’re taking. That way, you get personalized care that’s right for you.

Having so many services under one roof with your doctor makes getting care easier. And when your personal doctor and any specialists you need are all part of the same medical group and connected by the same system, consultations, diagnoses, and treatments come together smoothly.

In the end, all of this coordinated care means you’re saving time, saving money on unnecessary tests and trips to the doctor, and getting peace of mind.

STAYING HEALTHY

Preventive care is key to how we practice medicine at Kaiser Permanente. It can help you avoid some health issues and catch others before they become serious. To catch problems early, we offer preventive screenings, routine appointments, and more. Your electronic health record plays a vital role—the system tracks your preventive care services and triggers automatic reminders

when you’re due for your next screening. We’ll let you know when to come in, so you’re free to focus on living your life. And because good health goes beyond the doctor’s office, we have classes, wellness coaching, and programs to help you thrive.

WHEN YOU’RE SICK

We’re here for you. Our commitment to prevention is matched by our drive to get you to your healthy best. Great doctors, state-of-the-art facilities, and the latest technology all combine to help you recover.

If you have a condition such as asthma, diabetes, or heart disease, we’ll work with you to manage it using proven

best practices and advanced technology. Our well-rounded approach supports you physically and emotionally to help you continue living life to the fullest.

SIMPLER, SMARTER, HEALTHIER CARE DESIGNED FOR YOU

Discover the rewards of wellness.Receive up to $1,000 6 per household — learn more on page 16.

Learn more at my.kp.org/shbp

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HOW AND WHERE YOU NEED IT CARE

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IN-PERSON VISIT WITH YOUR PERSONAL DOCTOR OR SPECIALIST

Most of our locations have many services under one roof,* so you can see your doctor, get lab services or X-rays, and pick up a prescription—all in the same trip. We also offer same-day and next-day appointments for many services at several of our locations. See them all on page 24.

24/7 NURSE ADVICE

Have questions? Not sure what kind of care you need? You can call our local, specially trained Kaiser Permanente nurses anytime. If you receive care in our facilities, the nurses are connected to your doctor, can see your health record and help figure out what type of care you may need, and can even schedule a routine or Urgent Care appointment for you. $0 co-pay.

AT HOME, WORK, OR ON THE GO

Stay on top of your care 24/7 through kp.org or from any mobile device through the KP app. If you receive care in Kaiser Permanente facilities, you can view your medical record, refill most prescriptions, schedule and cancel routine appointments, get vaccination records, see most lab results, and more. For information on the KP app, visit kp.org/mobile.

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How, when, and where do you want to receive care? How do you want to manage your health? When you get care at Kaiser Permanente, you get care that fits your life.

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*When you get care at Kaiser Permanente facilities.

http:// kp.orghttp://kp.org/mobile

EMAIL

Email your doctor’s office anytime with non-urgent questions. You’ll usually get a response within 2 business days, if not sooner.* $0 co-pay.

PHONE APPOINTMENTS You may be able to save a trip to the doctor’s office by having a phone appointment

with a physician to discuss your progress, talk about a new concern, or ask a question about your care.* $0 co-pay.

VIDEO APPOINTMENTS2

For some conditions, you can meet face-to-face online with your doctor* on your computer, smartphone, or tablet. Video visits are available for primary care, as well as a growing number of specialties, for members who are registered on kp.org and have seen their doctor in the past year. For certain minor issues, same-day video appointments are also available. $0 co-pay.

SPECIALTY CARE

Need to see a specialist? You get great care from Kaiser Permanente experts in more than 40 specialties—most without a referral. If needed, you also have access to certain affiliated specialists.

INPATIENT HOSPITAL CARE3

If you need inpatient care or are having a baby, you’ll have access to several of Atlanta’s most well-respected hospitals including Emory, Northside, and Children’s Healthcare of Atlanta. At some of our partner locations, you’ll get top-notch care from a Kaiser Permanente doctor who has direct access to your medical record, which means you’ll get the right care in the right place.

URGENT/SAME-DAY CARE If you need care quickly, we're here for you. For less serious symptoms, you

can schedule a same-day telephone or video appointment, or visit one of our offices offering same-day appointments. Three of our Kaiser Permanente medical centers offer 24/7 Urgent Care, where you'll also find lab, X-ray, and pharmacy under the same roof. You also have access to our affiliated Urgent Care locations, found on page 29.

EMERGENCY CARE If you ever need emergency care, you’re covered worldwide—anytime, anywhere.4

You can get care at any hospital emergency room, even if it's not affiliated with Kaiser Permanente.

CARE AWAY FROM HOME If you travel for vacation or work, or have a student going to school outside the area,

we’ll help with getting care. We can also help you before you leave town by checking to see if you need a vaccination, prescriptions refills, and more. Once you register at kp.org, you can see your health information online and email your Kaiser Permanente doctor’s office with non-urgent questions anytime.

CARE ANYWHERE

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*When you get care at Kaiser Permanente facilities.

Just call our 24/7 Away from Home Travel Line at 951-268-3900 5 or visit kp.org/travel.

http://kp.org/travel

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QUALITY CARESTARTS WITH QUALITY DOCTORS

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TOP-RATED DOCTORS

You have exclusive access to a broad network of physicians. With over 500 hand-picked doctors and specialists trained at top schools like Emory, Duke, and Harvard, you can rest easy knowing you’ll have plenty of amazing physicians to choose from. And if you decide to switch to a new doctor, no problem. It’s your call. No matter which personal doctor you choose, you’ll be in highly skilled, experienced hands—with your health and your best life as the priority.

CHOOSE YOUR DOCTOR — AND CHANGE ANY TIME

At kp.org/searchdoctors, you can learn all about our physicians, including their education, credentials, and what makes them thrive, so you can connect with a doctor that's right for you.

You can choose your personal doctor from:

• Adult medicine/internal medicine • Family medicine • Pediatrics/family medicine

(for children up to 18)

We pioneered how an integrated care delivery system, with its own specialists and multidisciplinary care teams, can prevent disease and provide high-quality care. Every day, we make a commitment to early detection, cutting-edge research, and superior individualized and evidence-based medical care, delivered with compassion.

Watch members talk about their care experiences at kp.org/carestories.

“Kaiser Permanente’s integrated system is a better place to get health care. I had previously resisted going to an HMO, wanting to choose my own doctors, but Kaiser’s are better than the ones I chose before.”

–Scott, Kaiser Permanente member

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http://kp.org/searchdoctors

TECHNOLOGY TURBOCHARGES OUR CARE

Every Permanente physician is connected to one another—and to a wide range of care givers, including nurses, lab technicians, and pharmacists—through the world’s largest civilian electronic health records system, allowing each of them to be up-to-date about information on their patients’ care. This connectivity means faster, better-informed decisions from physicians and sound treatment paths for you.

Our physicians are empowered to:

• Discuss patient issues, diagnoses, and treatment options with one another in real time.

• Analyze data from more than 9 million records to detect signs of emerging chronic conditions and identify treatments that produce the best results.

• Access innovative health management tools.

Our physicians practice in numerous medical and surgical specialties and sub-specialties:

• Allergy • Neurology• Cancer care/oncology • Pain management• Cardiology • Pediatric specialties• Dermatology • Rheumatology• Endocrinology • Urology• Gastroenterology • Many more• High-risk pregnancy

CONTINUING YOUR CARE WITH SPECIALISTS

Referrals are typically not needed for you to see a Kaiser Permanente specialist. As your advocate, your doctor will discuss specialty care with you—including which specialist is best for you to see—and can directly book an appointment for you to see that specialist. He/she can also immediately order lab work, X-rays, and other tests. That not only helps you get to

the right care when you need it, but also helps keep you from getting bounced around from specialist to specialist.

We have doctors practicing in numerous medical and surgical specialties. They are experts in their fields and work together with your primary care doctor and others to diagnose and help you decide on the best course of care, whether you

have a broken bone, are facing a new disease, or have an ongoing medical condition. Many are recognized as top doctors by major local publications.

OUR DOCTORS = HEALTHIER YOU

kp.org/searchdoctorsChoose your doctor, change at any time

YOUR PCPYOU

When you need specialty care, you’re not on your own to find doctors, secure appointments, arrange for your own tests, forward and share results among physicians, coordinate prescriptions, or get approvals from an insurance company. Instead, your primary care doctor will navigate the process on your behalf.

WHEN YOU NEED SPECIALTY CARE, YOU’RE NOT ON YOUR OWN

When you need specialty care, you’re not on your own to find doctors, secure appointments, arrange for your own tests, forward and share results among physicians, coordinate prescriptions, or get approvals from an insurance company. Instead, your primary care physician will navigate the ins and outs for you.

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http://kp.org/searchdoctors

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ACTIVE TOGETHER HAPPY TOGETHER HEALTHY TOGETHER

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YOUR LIFE, HEALTHIER

PROGRAMS TO HELP YOU THRIVE

No-cost health and wellness classes • Online programs and tools • Wellness coaching • More

We believe that joy is the key to motivation. When you find the healthy thing you love to do, you'll be more motivated to do it—bringing you closer to reaching your goals every day. Read on—you’ll find suggestions for how to engage your body, mind, and spirit. Why not explore the tools that can help you thrive?

MOVE

Being active helps you be healthier and stronger, and feel your best, at every age. Whether you're a couch potato imagining a more active life, a senior with a few aches, a busy parent, or a weekend warrior, it can be tough to start, and keep moving. That's why we've put together some tips and inspiration to help. We’ve got:

• Local programs and classes, from dancercise to yoga

• Ideas for fun activities that can get your whole family moving

• Tools and apps to help you start a fitness routine and track your fitness

It’s all at kp.org/fitness.

LISTEN AND WATCH

Check out our Pandora Relaxation Radio station (choosing a health plan might be more fun when you're listening to some tunes). Download podcasts about health conditions, emotional wellness, and more. Some use guided imagery to help you quit smoking or lose weight. Our videos are also a great way to get information about living healthier or about medical conditions. The feast for your eyes and ears is at kp.org/podcasts.

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Open here to learn how to get up to $1,0006 per household in rewards!

http://kp.org/fitnesshttp://kp.org/podcasts

COACHING, CLASSES, AND MORE

kp.org/healthylivingWellness information, health calculators, videos, podcasts, and recipes.

kp.org/healthylifestylesOnline programs to help you lose weight, quit smoking, reduce stress, and more, all at no cost.

kp.org/classesNo-cost and low-cost classes and support groups at many of our facilities.

kp.org/wellnesscoachOne-on-one personal wellness coaching by phone to help you reach your health goals, at no cost.

kp.org/choosehealthy or 877-335-2746Learn about reduced rates on products and services that can help you stay healthy, such as massage therapy, chiropractic care, acupuncture, and more.

Help to quit smokingWe’ll help you succeed in quitting. You pay nothing for Kaiser Permanente classes, telephone coaching, online programs, and certain prescriptions, including prescribed over-the-counter tobacco-cessation drugs. Ask your doctor about your treatment options.

Learn more at my.kp.org/shbp

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HEALTHIER LIVING. REWARDED. 2019 WELLNESS PROGRAM

Each member and covered spouse who satisfies the Kaiser Permanente Wellness Program requirements below will receive a $500 reward card6—$1,000 per household to spend on anything!

Getting your reward is easy. Just sign on to my.kp.org/shbp to accept your Wellness Program agreement, then complete the 4 activities below. For details or questions, call 866-300-9867.

What to Do

Step 1Take Your Total Health AssessmentComplete your 2019 Kaiser Permanente Total Health Assessment (THA) online. The questionnaire is confidential and takes about 20 minutes.

Step 2

Know Your NumbersComplete a Biometric Screening either at a Kaiser Permanente medical office, or by a Kaiser Permanente clinician at an SHBP-sponsored screening event. Visit kp.org/wellnessevent and use the signup code SHBP for a list of upcoming events.ONLY those screenings performed by Kaiser Permanente are eligible for the reward.

Step 3Get Yourself ScreenedComplete all age and gender appropriate preventive screenings for breast, cervical, or colorectal cancer.

Step 4 Take an Online CourseComplete one online Healthy Lifestyle Program (HLP).

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EARN UP TO

$1,0006

http://kp.org/healthylivinghttp://kp.org/healthylifestyleshttp://kp.org/classeshttp://kp.org/wellnesscoachhttp://kp.org/choosehealthyhttp://my.kp.org/shbphttp://my.kp.org/shbphttp://kp.org/wellnessevent

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A PLAN WITH BENEFITSSIMPLE CO-PAYS, NO DEDUCTIBLES, VIRTUALLY NO PAPERWORK

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THE RIGHT CHOICE FOR YOUR HEALTH

Get great care and the resources you need to live healthier — all in one convenient package. Check out everything that comes with your health plan, and see why more than 10 million people nationwide choose Kaiser Permanente.

STATE HEALTH BENEFIT PLAN

You get a wide range of care and support options to help you stay healthy and get the most out of life. There are no deductibles to keep track of and usually no paperwork to worry about for the services you receive. And when you come in for care, you’ll pay just a co-pay for most services covered by your plan.

Simple co-pays, including prescriptions

No paperwork to fill out or bills for covered services you receive

No deductibles to meet

No referrals for most specialties, like optometry and obstetrics-gynecology

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2120 Enroll today! mySHBPga.adp.com

Mental Health and Chemical DependencyMental Health Outpatient (Individual) $35 co-pay, unlimited visits per calendar year

Mental Health Outpatient (Group) $17 co-pay, unlimited visits per calendar year

Mental Health Inpatient $250 co-pay, unlimited days per calendar year

Chemical Dependency Outpatient (Individual) $35 co-pay, unlimited visits per calendar year

Chemical Dependency Outpatient (Group) $35 co-pay, unlimited visits per calendar year

Chemical Dependency Inpatient $250 co-pay, unlimited days per calendar year

Prescription DrugsDay Supply 30-Day Supply

Generic Preferred $20 co-pay at KP Pharmacies & $30 co-pay at Network Pharmacies for 1x fill 9

Brand Preferred $50 co-pay at KP Pharmacies & $60 co-pay at Network Pharmacies for 1x fill 9

Non-Preferred $80 co-pay at KP Pharmacies & $90 co-pay at Network Pharmacies for 1x fill 9

Mail Order – Day Supply 90-Day Supply

Mail Order – Generic Preferred $50 co-pay through Kaiser Permanente Pharmacies only

Mail Order – Brand Preferred $125 co-pay through Kaiser Permanente Pharmacies only

Mail Order – Non-Preferred $200 co-pay through Kaiser Permanente Pharmacies only

OtherSkilled Nursing Facility (SNF) Plan pays 100%, up to 120 days per calendar year

Hospice Care Covered at 100%

Home Health Care Plan pays 100%, unlimited. Private Duty Nursing is not covered.

Durable Medical Equipment (DME) Covered at 100%, unlimited

Chiropractic Care $45 co-pay, up to 20 visits per calendar year

Hearing (Non-routine Exams, Tests & Fittings) • Hearing Aids limited to $1,500 every 5 yrs for Adults• Combined Benefit Maximum: $3,000 per aid; per ear;

every 48 months for Children 18 years and younger

Covered at 100%

Infertility Diagnosis Office VisitLimited to diagnostic services for the diagnosis of involuntary infertility only.

$45 co-pay

Infertility Diagnosis Only Laboratory, Radiology and Tests Limited to diagnostic services for the diagnosis of involuntary infertility. Tests covered under “Diagnosis Only” are those only to rule out underlying medical issues. Tests and treatment related to reproductive issues are not covered.

Covered at 100% for services performed in a Kaiser Permanente Medical Center or a freestanding laboratory contracted with Kaiser Permanente; $100 co-pay for services performed in an outpatient hospital setting.

STATE HEALTH BENEFIT PLAN (SHBP)7Effective Dates: January 1, 2019 - December 31, 2019

Work or Reside The State Health Benefit Plan members (and eligible dependents) are eligible to enroll in Kaiser Permanente if they work or live within the Service Area at the time of enrollment.10

Deductible, Co-insurance & Out-of-Pocket MaximumsAnnual Deductible: Individual/Family

$0

Co-insuranceNONE

Lifetime Benefit Maximum

Unlimited

Office Visits (Outpatient)Primary Care $35 co-paySpecialty Care $45 co-pay

Scheduled Prenatal Visits and 1st Postpartum Visit Routine care covered at 100%

Vision Exam $0 co-pay, includes refractions Telemedicine/Virtual Visit2 Covered at 100%

Physical, Occupational, Speech Therapy, Cardiac Rehab

$25 co-pay, up to 40 visits per calendar year for each therapy

Outpatient/Ambulatory Surgery $100 co-pay

Routine Preventive Care8

Wellness Exams—Physical and Well Woman exams

Covered at 100%

Mammography Screening• Mammography screening for

breast cancer for women over 40.• Mammography screening for

breast cancer in other age groups as jointly determined by patient and physician

Covered at 100%

Pap Smear Covered at 100%

Prostate Specific Antigen (PSA) TestProstate cancer screenings (PSA and digital rectal exams)

Covered at 100%

Sigmoidoscopy/Colonoscopy Covered at 100%

Well Child Care Covered at 100%

Breast Cancer Medications (Tamoxifen & Raloxifene only) Covered at 100%

Lab & X-Ray

Laboratory

Covered at 100% for services performed in a Kaiser Permanente Medical Center or a freestanding laboratory contracted with Kaiser Permanente; $100 co-pay for services performed in an outpatient hospital setting.

X-Ray

Covered at 100% for services performed in a Kaiser Permanente Medical Center or a freestanding imaging center contracted with Kaiser Permanente; $100 co-pay for services performed in an outpatient hospital setting.

MRI/CT/PET/Nuclear Medicine

$45 co-pay per scan for services performed in a Kaiser Permanente Medical Center or a freestanding imaging center contracted with Kaiser Permanente; $100 co-pay when imaging is performed in outpatient hospital setting.

Emergency CareAmbulance (Ground or Air) $100 co-pay (per trip)

Emergency Room$150 co-pay (per visit); waived if admitted

Urgent Care$35 co-pay, at designated facilities

Hospital Care (Inpatient)Inpatient $250 co-pay, per admission

Delivery and Inpatient Baby Care $250 co-pay, per admission

Need help? Call your Dedicated Member Services line at 855-512-5997 Monday – Friday, 7am – 7pm and learn how to get the most of your membership.

http://mySHBPga.adp.com

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Athens

Panola

Southwood

Stonecrest

Gwinnett

Crescent

Downtown Decatur

TownPark

Glenlake

Holly Springs

Douglasville

West Cobb

Alpharetta

Cumberland

Sugar Hill–Buford

Henry Towne Centre

Forsyth

Cascade

Snellville

Conyers

Fayette

Newnan

Sandy Springs

Brookwood at Peachtree

Southwood Specialty

Lawrenceville

CUMBERLAND DOWNTOWN DECATUR DOUGLASVILLE

CRESCENTALPHARETTA BROOKWOOD AT PEACHTREE CASCADE CONYERS

WEST COBBSUGAR HILL-BUFORD

SNELLVILLESANDY SPRINGS

STONECREST

HOLLY SPRINGS LAWRENCEVILLE

PANOLANEWNAN

HENRY TOWNE CENTER

FORSYTH

GLENLAKE

FAYETTE

GWINNETT

24/7 URGENT CARE

SOUTHWOOD

24/7 URGENT CARE

TOWNPARK

24/7 URGENT CARE

With your choice of great doctors and convenient locations throughout metro Atlanta, it’s easy to get the care you need. Most locations offer multiple services under one roof—so you can see your doctor, get a lab test or X-ray, and pick up your medications, all without leaving the building.

SOUTHWOOD SPECIALTY

CARE THAT'S CLOSE BY

?

CT/MRIGlenlakeGwinnett

SouthwoodStonecrest*

TownPark

DEXA ScanCascadeCrescentGwinnett

SouthwoodTownPark

MammographyAlpharetta

CascadeCrescent

CumberlandHenry Towne

GlenlakeGwinnett

PanolaSouthwoodTownPark

UltrasoundCrescentGlenlakeGwinnett

SouthwoodTownPark

Audiology

GlenlakeGwinnett

SouthwoodSpecialty

Southwood

Bariatric Surgery

Behavioral Health

Cardiology

CascadeGlenlakeGwinnett

SouthwoodSouthwood

SpecialtyTownPark

Child Psychiatry

Dermatology

CrescentCumberland

GwinnettSandy Springs

SouthwoodSouthwood

SpecialtyTownPark

EndocrinologyCumberland

GwinnettSouthwood

Specialty

Gynecology

DecaturDouglasvilleHenry Towne

StonecrestSugar Hill-Buford

Gastroenterology

GlenlakeGwinnett

SouthwoodTownPark

General Surgery

GeriatricsCumberland

GwinnettSouthwood

Specialty

Geriatric PsychiatryCumberland

Hand SurgeryGlenlakeGwinnett

SouthwoodTownPark

Hematology/Oncology

Infectious Disease

Glenlake AlpharettaBrookwood

CascadeCrescent

CumberlandGwinnett

Sandy SpringsSouthwoodStonecrestTownPark

AlpharettaCrescent

CumberlandGwinnett

Sandy Springs

GlenlakeGwinnett

SouthwoodTownPark

GwinnettSouthwoodTownPark

BrookwoodCumberland

GwinnettSouthwood

Specialty

?

NephrologyCascadeCrescent

CumberlandGwinnett

PanolaSouthwood

Specialty

NeurologyCrescentGlenlakeGwinnett

SouthwoodTownPark

OB/GYN

AlpharettaCascadeCrescent

CumberlandGlenlakeGwinnett

PanolaSouthwoodTownPark

Orthopedic/Sports Medicine

GlenlakeGwinnett

SouthwoodTownPark

Optometry/Ophthalmology

GlenlakeGwinnett

SouthwoodTownPark

OtolaryngologyGlenlakeGwinnett

SouthwoodSpecialty

Southwood

Pain Management

Palliative Care

PerinatologyBrookwood

Glenlake

Plastic Surgery

PodiatryCumberland

CrescentGlenlakeGwinnett

Southwood

PsychiatryBrookwood

CascadeCrescent

CumberlandGwinnett

Sandy SpringsStonecrestSouthwoodTownPark

PsychologyCrescent

CumberlandGwinnett

Sandy SpringsStonecrestSouthwoodTownPark

PulmonologyGlenlakeGwinnett

SouthwoodTownPark

RheumatologyCumberland

GwinnettSouthwood

Specialty

Sleep Medicine

UrologyGlenlakeGwinnett

Southwood

Vascular Surgery

CumberlandGlenlakeGwinnett

Southwood

CumberlandSouthwood

SpecialtyGwinnett

GlenlakeSouthwood

Cumberland GlenlakeSouthwood

SPECIALTIES AND LOCATIONS

Adult, Family and Pediatric

Medicine

Lab

Pharmacy

Services available at most Kaiser Permanente

medical centers

X-Ray

Specialties and locations subject to change. Call Member Services at 855-512-5997 to find a service near you.

Primary Care Diagnostic Imaging Specialty Services

24 25 * MRI only

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WALTON

BARROW

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FULTON

CHEROKEEBARTOW

PAULDING

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PICKENS

DAWSON

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GWINNETT

HARALSON

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MERIWETHERPIKE

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Athens

Panola

Southwood

Stonecrest

Gwinnett

Crescent

Downtown Decatur

TownPark

Glenlake

Holly Springs

Douglasville

West Cobb

Alpharetta

Cumberland

Sugar Hill–Buford

Henry Towne Centre

Forsyth

Cascade

Snellville

Conyers

Fayette

Newnan

Sandy Springs

Brookwood at Peachtree

Southwood Specialty

Lawrenceville

CARE WHEN AND WHERE YOU NEED IT

Skip the trip. Ask about a video visit.

Call 404-365-0966.

KP

KP

Kaiser Permanente Medical Facilities

Kaiser Permanente Comprehensive Medical Centers

Affiliated Urgent Care Centers

Affiliated Hospitals

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CHEROKEE COUNTY

Holly Springs Medical Office684 Sixes Rd., Ste. 275 Holly Springs, GA 30115770-852-2440

CLAYTON COUNTY

Southwood Comprehensive Medical Center 2400 Mt. Zion Pkwy. Jonesboro, GA 30236 770-603-3649

Southwood Specialty Center 2470 Mt. Zion Pkwy. Jonesboro, GA 30236 404-365-0966

COBB COUNTY

Cumberland Medical Center2525 Cumberland Pkwy. SE Atlanta, GA 30339770-431-4235

TownPark Comprehensive Medical Center 750 TownPark Ln. Kennesaw, GA 30144 770-514-5401

West Cobb Medical Center 3640 Tramore Pointe Pkwy. Austell, GA 30106 770-439-4700

COWETA COUNTY

Newnan Medical Office 205 Newnan Crossing Bypass Newnan, GA 30263 770-304-4400

DEKALB COUNTY

Crescent Medical Center200 Crescent Centre Pkwy. Tucker, GA 30084 770-496-3414

Downtown Decatur Medical Office 201 W. Ponce de Leon Ave. Ste. A Decatur, GA 30030 404-687-7700

Panola Medical Center 5440 Hillandale Dr. Lithonia, GA 30058 770-322-2777

Stonecrest Medical Center8011 Mall Pkwy. Lithonia, GA 30038678-323-7500

DOUGLAS COUNTY

Douglasville Medical Office6875 Douglas Blvd., Ste. A Douglasville, GA 30135678-838-2225

FAYETTE COUNTY

Fayette Medical Office101 Banks Rd. Fayetteville, GA 30214 678-610-3700

FORSYTH COUNTY

Forsyth Medical Office1400 Northside Forsyth Dr. Ste. 350 Cumming, GA 30041 678-455-1407

FULTON COUNTY

Alpharetta Medical Center3550 Preston Ridge Rd. Alpharetta, GA 30005 770-663-3110

Brookwood at Peachtree Medical Office1745 Peachtree Rd., Ste. U Atlanta, GA 30309 404-888-7688

Cascade Medical Center1175 Cascade Pkwy. Atlanta, GA 30311 404-505-4006

Glenlake Comprehensive Specialty Center 20 Glenlake Pkwy. Sandy Springs, GA 30328 770-677-6075

Sandy Springs Medical Office 1100 Lake Hearn Dr. NE Suites 250 and 500 Atlanta, GA 30342 404-845-4500

GWINNETT COUNTY

Gwinnett Comprehensive Medical Center3650 Steve Reynolds Blvd. Duluth, GA 30096 770-931-6012

Lawrenceville Medical Office455 Philip Blvd., Ste. 130 Lawrenceville, GA 30046678-985-5000

Snellville Medical Office2240 Fountain Dr. Snellville, GA 30078770-978-5400

Sugar Hill–Buford Medical Center1435 Broadmoor Blvd. Sugar Hill, GA 30518678-765-5700

HENRY COUNTY

Henry Towne Centre Medical Center1125 Towne Centre Village Dr. McDonough, GA 30253678-583-6600

ROCKDALE COUNTY

Conyers Medical Office1478 Dogwood Dr. Conyers, GA 30013 678-413-4320

KAISER PERMANENTE MEDICAL FACILITIES

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24/7Advanced Urgent Care

Same-day Express Care

CONVENIENT CARE NEAR YOU

It’s easy to find a Kaiser Permanente medical center near home or work. You’ll find same-day, next-day, and after-hours options available. Just hop online or grab your smartphone or tablet to search by ZIP code, keyword, or the service you want. kp.org/facilities.

TELEHEALTH

Get care with no drive, no wait, and no co-pay with telehealth options like video and telephone visits. Whether you're at home or traveling, you’ll find a range of same-day or ‘soon-day’ telehealth services to fit your needs, from adult care to pediatrics to specialty follow-ups. Just like an in-person visit, your telehealth care team has real-time access to your medical records and can even prescribe medications. my.kp.org/shbp/telehealth

URGENT CARE + 24/7 ADVANCED CARE

When you need care quickly, same day appointments are often available. 3 of our locations offer 24/7 advanced urgent care, where lab, X-ray, and pharmacy are all in the same building. You also have access to numerous affiliated urgent care locations throughout metro Atlanta and while traveling. Just call 404-365-0966 for help finding the care that's right for you.

HOSPITAL PARTNERS

You deserve the best care at all times. That’s never more important than when you need a hospital. If you need inpatient care, or are having a baby, you'll have access to several of Atlanta's most well-respected hospitals, including Emory, Northside, and Children's Healthcare of Atlanta. At some of our partner locations, you'll get care from a Kaiser Permanente doctor who has direct access to your medical record, which means you'll get top-notch integrated care when it matters most.

EMERGENCY CARE

If you ever need emergency care, you’re covered worldwide—anytime, anywhere.4

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http://kp.org/facilitieshttp://my.kp.org/shbp/telehealth

AFFILIATED

HOSPITALS

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METRO ATLANTA

Children’s Healthcare at Egleston 404-785-6000

Children’s Healthcare at Scottish Rite 404-785-5252

Emory Johns Creek Hospital 678-474-7000

Emory Saint Joseph's Hospital 678-843-7001

Emory University Hospital 404-712-2000

Emory University Hospital Midtown 404-686-4411

Gwinnett Medical Center–Duluth 678-312-6800

Gwinnett Medical Center–Lawrenceville 678-312-4321

Northside Hospital 404-851-8000

Northside Hospital Cherokee 770-720-5100

Northside Hospital Forsyth 770-844-3200

Piedmont Hospital 404-605-5000

Piedmont Fayette Hospital 770-719-7000

Piedmont Henry Hospital 770-389-2200

Piedmont Mountainside Hospital 706-692-2441

Piedmont Newnan Hospital 770-400-1000

Piedmont Newton Hospital 770-786-7053

AFFILIATED COMMUNITY

URGENT CAREBARROW COUNTY

Regional FirstCare 678-963-7171

CARROLL COUNTY

Peachtree Immediate Care 770-456-0911

CHEROKEE COUNTY

Children's at Cherokee Urgent Care 404-785-5437

MedPost Urgent Care 770-517-4621

Northside Family Medicine & Urgent Care of Holly Springs 678-426-5450


CLAYTON COUNTY

Concentra Urgent Care Conley 404-366-2900

Concentra Urgent Care Morrow 678-422-8824

COBB COUNTY

Children's at Town Center 404-785-8010

Concentra Urgent Care Marietta 770-424-7125

MedPost Urgent Care at East Cobb

770-971-5494

Northside Family Medicine & Urgent Care of East Cobb 770-509-1025

Peachtree Immediate Care Acworth 770-974-3911

Peachtree Immediate Care Kennesaw 770-423-0000

Summit Urgent Care at Marietta 770-832-4147

COWETA COUNTY

Summit Urgent Care Newnan 770-502-2021

DAWSON COUNTY

Northside Family Medicine & Urgent Care of Dawsonville 706-216-6000

DEKALB COUNTY

Children's at Chamblee Brookhaven 404-785-5437

Urgent Care at Druid Hills 678-805-7981

Peachtree Immediate Care Decatur 404-634-4443

DOUGLAS COUNTY

Get Well Urgent Care Douglasville 404-937-3508

Peachtree Immediate Care Douglasville 770-947-1112

FAYETTE COUNTY

Peachtree City Urgent Care 770-487-2273

Summit Urgent Care Fayetteville 770-835-4925

Summit Urgent Care Peachtree City 770-847-8786

FORSYTH COUNTY

Children's at Forsyth 404-785-8900

Northside Family Medicine & Urgent Care of Cumming 770-205-2804


FULTON COUNTY

Bethany Bend Urgent Care 770-521-6690

Children's at North Point 404-785-3020

Concentra Urgent Care Hapeville 404-768-3351

Concentra Urgent Care Atlanta 404-344-3930

Concentra Urgent Care 404-881-1155

Concentra Urgent Care Sandy Springs 678-812-2277

Concentra Urgent Care Duluth 770-441-0444

MedPost Urgent Care Atlanta 404-344-7286

MedPost Urgent Care Alpharetta 770-343-6364


North Atlanta Urgent Care II 404-327-8744

Northside Family Medicine & Urgent Care of Roswell 770-619-3860

Roswell Urgent Care 770-992-4700

Summit Urgent Care 404-344-7337

Urgent Care at Peachtree 678-805-7425

1 Kaiser Foundation Health Plan of Georgia has been the top-ranked commercial plan in Georgia for 9 consecutive years and the top-rated commercial plan in Georgia for 3 years. NCQA’s Private Health Insurance Plan Ratings 2017–2018, National Committee for Quality Assurance, 2017: Kaiser Foundation Health Plan of Georgia, Inc. — HMO (rated 4 out of 5); NCQA’s Private Health Insurance Plan Ratings 2016–2018, National Committee for Quality Assurance; NCQA’s Private Health Insurance Plan Rankings 2006–2015, National Committee for Quality Assurance.

2 Video appointments with primary care physicians (PCPs) available only with Permanente physicians for certain medical conditions. For members 18 and older who are registered on kp.org and have seen their doctor in the past year. Ask if a phone or video visit is right for you. Just call 404-365-0966.

3 The hospital you will be admitted to for inpatient care is determined by the primary care physician you select. Some locations are available only in specific cases. In an emergency, you have access to any hospital emergency room.

4 If you reasonably believe you have an emergency medical condition, which is a medical or psychiatric condition that requires immediate medical attention to prevent serious jeopardy to your health, call 911 or go to the nearest emergency department. For the complete definition of an emergency medical condition, please refer to your Evidence of Coverage.

5 This number can be dialed from inside and outside the United States. Outside, you must dial the U.S. country code “001” for land lines and “+1” for mobile before the phone number. Long-distance charges may apply, and we cannot accept collect calls. This phone line is closed on major holidays.

6 Each member and covered spouse who satisfies the Kaiser Permanente Wellness Program requirements will receive a $500 rewards card, up to $1000 per household. Your rewards card expires 12 months from date issued. Please call the phone number on the back of your reward card for specific information regarding terms and conditions.

7 This is a summary of your benefits and their co-pays. This is not a contract. A complete list, exclusions and limitations are

contained in the Evidence of Coverage. In the case of a conflict between this benefit summary and the Evidence of Coverage, the Evidence of Coverage will prevail. For specific questions about coverage, please contact Kaiser Permanente Member Services at 855-512-5997.

8 Preventive Services are based on recommendations by the United States Preventive Services Task Force, the Health Resources and Service Administration and the Centers for Disease Control and Prevention. Additional services are mandated by the State of Georgia. We will cover all federal and state mandated benefits as required by law. Kaiser Permanente health professionals will determine if services are medically necessary for each member. A service is considered medically necessary if it’s medically required to prevent, diagnose or treat a member’s condition or clinical symptoms and it’s consistent with generally accepted professional standards of care in the community. (Preventive Services must be coded as preventive, state-mandated, a screening, age-appropriate, meet frequency guidelines and be delivered by a network provider).

9 For immediate service after an emergency visit, prescriptions may be filled at Rite Aid or Walgreens at a co-pay $10 higher than those listed above. This is for a first fill ONLY per prescription. Subsequent refills must be filled through Kaiser Permanente Pharmacies, either at our facilities or through our mail order/home delivery option. Please note: Kaiser Permanente has extended pharmacy hours at our Southwood, TownPark, and Gwinnett Comprehensive Medical Centers—Monday- Sunday 7:00 a.m.–11:00 p.m. ET. Most Kaiser Permanente medical offices have a pharmacy located on-site, several with evening and weekend hours. For details, please contact Kaiser Permanente Member Services at 855-512-5997.

10 You must live or work in one of the below 27 counties within the Metro Atlanta Service Area to be eligible to enroll in KP: Barrow, Bartow, Butts, Carroll, Cherokee, Clayton, Cobb, Coweta, Dawson, DeKalb, Douglas, Fayette, Forsyth, Fulton, Gwinnett, Haralson, Heard, Henry, Lamar, Meriwether, Newton, Paulding, Pickens, Pike, Rockdale, Spalding, Walton.

ENDNOTES

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GWINNETT COUNTY

Children's at Satellite Boulevard 404-785-8330

Children's at Hamilton Creek 404-785-5437

ChoiceOne Urgent Care Buford 470-326-7300

ChoiceOne Urgent Care Sugar Hill 470-326-7600

Concentra Urgent Care Norcross 770-242-7744

Concentra Urgent Care Lawrenceville 770-995-1500

Gwinnett Urgent Care 770-831-5525

Peachtree Immediate Care Buford 678-546-0200

Peachtree Immediate Care Norcross 770-263-1000

Peachtree Immediate Care Duluth 770-476-3000

Sugarloaf Urgent Care 470-375-5940

HENRY COUNTY

Children's at Hudson Bridge 404-785-8660


PAULDING COUNTY

New Hope Urgent Care 770-443-6111


ROCKDALE COUNTY

Concentra Urgent Care 866-944-6046

WALTON COUNTY

Monroe Reddy Urgent Care 706-363-9228

AFFILIATED COMMUNITY

URGENT CARE

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60577109_ACA_1557_MarCom_GA_2017_Taglines_Landscape

NONDISCRIMINATION NOTICE Kaiser Foundation Health Plan of Georgia, Inc. (Kaiser Health Plan) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Kaiser Health Plan does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. We also: • Provide no cost aids and services to people with disabilities to communicate effectively with us, such as:

• Qualified sign language interpreters • Written information in other formats, such as large print, audio, and accessible electronic formats

• Provide no cost language services to people whose primary language is not English, such as: • Qualified interpreters • Information written in other languages

If you need these services, call 1-888-865-5813 (TTY: 711) If you believe that Kaiser Health Plan has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance by mail at: Member Relations Unit (MRU), Attn: Kaiser Civil Rights Coordinator, Nine Piedmont Center, 3495 Piedmont Road, NE Atlanta, GA 30305-1736. Telephone Number: 1-888-865-5813. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Avenue SW., Room 509F, HHH Building, Washington, DC 20201, 1-800-368-1019, 1-800-537-7697 (TDD). Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

________________________________________________________________________________________________

HELP IN YOUR LANGUAGE ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-888-865-5813 (TTY: 711).

አማርኛ (Amharic) ማስታወሻ: የሚናገሩት ቋንቋ ኣማርኛ ከሆነ የትርጉም እርዳታ ድርጅቶች፣ በነጻ ሊያግዝዎት ተዘጋጀተዋል፡ ወደ ሚከተለው ቁጥር ይደውሉ 1-888-865-5813 (TTY: 711).

، فإن خدمات العربيةإذا كنت تتحدث :ملحوظة (Arabic) العربية 5813-865-888-1 اتصل برقم. المساعدة اللغوية تتوافر لك بالمجان

(TTY :711.) 中文 (Chinese) 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-888-865-5813 （TTY：711）。

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60577109_ACA_1557_MarCom_GA_2017_Taglines_Landscape

اگر به زبان فارسی گفتگو می کنيد، توجه: (Farsi) فارسی تسهيالت زبانی بصورت رايگان برای شما فراهم می باشد.

تماس بگيريد.TTY) 1-888-865-5813: 711) با Français (French) ATTENTION: Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-888-865-5813 (TTY: 711).

Deutsch (German) ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-888-865-5813 (TTY: 711).

ગજુરાતી (Gujarati) સચુના: જો તમે ગજુરાતી બોલતા હો, તો નન:શલુ્ક ભાષા સહાય સેવાઓ તમારા માટે ઉપલબ્ધ છે. ફોન કરો 1-888-865-5813 (TTY: 711). Kreyòl Ayisyen (Haitian Creole) ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 1-888-865-5813 (TTY: 711).

हिन्दी (Hindi) ध्यान दें: यहद आप हििंदी बोलते िैं तो आपके ललए मुफ्त में भाषा सिायता सेवाएिं उपलब्ध िैं। 1-888-865-5813 (TTY: 711) पर कॉल करें। 日本語 (Japanese) 注意事項：日本語を話される場合、無料の言語支援をご利用いただけます。1-888-865-5813 （TTY: 711）まで、お電話にてご連絡ください。

한국어 (Korean) 주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-888-865-5813 (TTY: 711) 번으로 전화해 주십시오.

Naabeehó (Navajo) Díí baa akó nínízin: Díí saad bee yáníłti’go Diné Bizaad, saad bee áká’ánída’áwo’dé̖é̖’, t’áá jiik’eh, éí ná hóló̖, koji̖’ hódíílnih 1-888-865-5813 (TTY: 711).

Português (Portuguese) ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para 1-888-865-5813 (TTY: 711).

Pусский (Russian) ВНИМАНИЕ: eсли вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-888-865-5813 (TTY: 711).

Español (Spanish) ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-888-865-5813 (TTY: 711).

Tagalog (Tagalog) PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-888-865-5813 (TTY: 711).

Tiếng Việt (Vietnamese) CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-888-865-5813 (TTY: 711).

THE RIGHT CHOICEFOR A HEALTHIER YOU

Having a good health plan is important. So is getting quality care. With Kaiser Permanente, you get both.

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youtube.com/kpganews

twitter.com/kpgeorgia

STAY CONNECTED TO GOOD HEALTH

LEARN MORE my.kp.org/shbp

ENROLL TODAY

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DEDICATED MEMBER SERVICES

855-512-5997

M-F, 7a - 7p ET

HEALTH LINE

404-365-0966

Appointment Scheduling or Prescription Help, M-F, 7a - 7p ET

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