Your Medical Options
As of July 1, 2021, the District offers the Kaiser Permanente HMO 20 Plus medical plan, DHMO 2000 20% Plus medical plan, and KP Select DHMO 3000 medical plan. Our group number for all three plans is 47139. You can also waive coverage.
How the Kaiser Permanente Medical Plans Work
These plans are accepted at the Kaiser Permanente medical facilities (locations listed below) and many affiliated (independent) providers in Colorado. Coverage is only provided in a designated service area based on where the member lives and/or works. (Note: If you are traveling outside the service area, urgent and emergency care are covered anywhere in the world.)
Each time you need medical care, you decide if you want to use a Kaiser Permanente provider, affiliate provider who participates in the network (in-network provider), or a non-affiliate provider (called an out-of-network provider). If you use an in-network provider, you'll receive a higher level of benefits than if you use an out-of-network provider. Out-of-network services are available on the Plus benefit tied to the HMO 20 and DHMO 2000 20% plans. For more information about the Plus benefit, please refer to the Plus Plan Member flyer and FAQ located in the File Library to the right.
The KP Select DHMO 3000 20% plan has a tailored network of affiliate providers compared to the other two plans. There are no out-of-network benefits for this plan and members of the KP Select DHMO 3000 20% plan can only go to a UCHealth hospital (Centura Health Urgent Care facilities, Penrose Hospital, and St. Francis Medical Center are NOT covered on this plan). Please review the Kaiser Permanente Member Guide located in the File Library to see a general list of covered providers.
To find a provider, log on to www.kp.org/doctorsandlocations or call member services at 1-855-364-3184. For helpful directions on finding a provider, click HERE. Your primary care physician can be either a Kaiser Permanente provider or one of the affiliate providers in the network. Please refer to Kaiser Permanente on specialist referral requirements.
Certain procedures require that your physician complete a pre-authorization form and submit it to the insurance carrier prior to the procedure being performed. Ultimately, it is your responsibility to ensure this has happened before moving forward with the procedure.
Click HERE to view a video from Kaiser Permanente providing an overview of health plans as well as information on care, coverage, perks, and no-cost healthy extras.
Kaiser Permanente Medical Office Locations:
3920 North Union Blvd.
Colorado Springs, CO 80907
215 Parkside Drive
Colorado Springs, CO 80910
4105 Briargate Parkway, Suite 125
Colorado Springs, CO 80920
2625 W. Pueblo Blvd
Pueblo, CO 81004
3670 Parker Blvd, Suite 200
Pueblo, CO 81008
Maintenance medication prescriptions (drugs taken regularly for ongoing conditions) can be filled for the first time through an in-person Kaiser Permanente medical facility or an affiliated plan pharmacy. Refills must go through the Kaiser Permanente medical facility or by mail-order. Non-maintenance prescriptions (drugs taken for a one-time or urgent condition) can be filled and/or refilled by the Kaiser Permanente medical facility or an affiliated plan pharmacy.
For a copy of the current pharmacy formulary list for all three plans, please visit kp.org/formulary and browse the HMO formulary for the Colorado region.
Certain drugs require that your physician complete a preauthorization form and submit it to the insurance carrier prior to your prescription being filled. Your doctor's office can obtain the necessary paperwork from the Kaiser provider portal or they can contact Kaiser to obtain a copy of the form.
Get More From Your Health Care
Your healthcare coverage is your most important benefit. Here are a few suggestions on how to make the most of your coverage.
- Use the man no-cost virtual care options like Chat with a Doctor, 24/7 Nurse advise line, on-demand or scheduled video visits
- Utilize in-network providers.
- Practice preventive medicine.
- If you are not sure what type of care you need, and it is safe to do so, contact the Kaiser Permanente 24/7 medical advice line for guidance. 303-338-4545 or 1-800-218-1059 TTY 771
- In an emergency go to the nearest emergency room. Use the emergency room for emergency situations only.
- Urgent care facilities are available for non-emergency situations and cost you less money. If safe to do so, contact the Kaiser Permanente 24/7 medical advice line for guidance or use kp.org to chat with a doctor.
- Utilize generic prescription drugs or the mail-order program whenever possible. For a mail-order prescription form click here.
- Register on www.kp.org/register to access additional services such as:
- Virtual care with a Kaiser Permanente medical team
- Order ID cards
- Check claim status
- Find a physician, hospital, facility
- AND MANY MORE!
Know Before You Go
Members should verify that the facility/provider they are using is in-network with Kaiser. That information can be obtained by (1) downloading the Kaiser Permanente mobile app, (2) visiting www.kp.org/doctorsandlocations, or (3) calling 1-855-364-3184 to talk to a Kaiser customer service representative. In the case of an urgent care visit, it is also recommended that members inquire at the facility/provider if the claim is going to be submitted to the insurance carrier as an Urgent Care or ER coded claim as the cost to the member would be substantially higher if the visit was coded as an ER claim.
A self-guided PowerPoint Presentation providing information about Kaiser Permanente Health Plans, Network options, online health management, TeleHealth, and much more.