Referrals
Under the Kaiser Permanente HMO model, all medical care must be coordinated by your Kaiser clinic. You cannot make a self-referral. Always call Kaiser prior to any treatment.
Non-Kaiser Treatment
If you go to any facility other than Kaiser and it is not based on a referral from a Kaiser physician or an acute life threating emergency, then you will be responsible for all medical expenses you incur.
Emergency Treatment
Kaiser defines an emergency as those services required for the alleviation of severe pain or immediate diagnosis and treatment of an unforeseen medical condition which, if not treated, would jeopardize or impair your health.
In the case of a life threatening emergency, obtain care immediately. After care is obtained, you must contact Kaiser within 24 to 48 hours after the onset of the emergency. A family member, co-worker, etc. may make this call on your behalf. In the case of a non-life threatening emergency, regardless of where you are, call Kaiser prior to receiving care. If you do not consult a physician at Kaiser first, you will be responsible for all charges for acute, non-life threatening emergency services.
Selecting a Clinic
You may visit any of the Kaiser Permanente clinics or hospitals in your service area. You are encouraged, but not required, to select a PCP for yourself and each dependent. Only care provided by Kaiser physicians and hospitals are covered under the plan.