FAQs

Kaiser Permanente was founded over 70 years ago with a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve.

Today, we are recognized as one of America’s leading health care providers. We currently serve over 12 million members in 8 states and the District of Columbia. We’ve been in metro Atlanta for over 30 years, and over 300,000 Georgians trust us with their healthcare. They also give us the highest customer loyalty ranking. *

Kaiser Permanente’s model is unique, because we’re not just your health coverage, we also provide your medical care. Our own Kaiser Permanente doctors work together with the health plan to make it simple to get quality, personalized care.

*Satmetrix® 2018 Net Promoter®

This is a new TRICARE Prime program option being offered in the metro Atlanta area. It is now available to eligible military retirees and their family members, and active duty family members.

The Kaiser Permanente TRICARE Prime option provides you with the same benefits and low costs of TRICARE Prime®. In addition, you’ll have access to the medical expertise, coordinated care, and timesaving convenience of Georgia’s top health plan, Kaiser Permanente.* Our over 800 carefully selected providers practice in 25 medical facilities throughout metro Atlanta.

* NCQA’s Private Health Insurance Plan Ratings/Rankings

Kaiser Permanente’s TRICARE Prime option is available in the metro Atlanta, Georgia area.

With Kaiser Permanente, you can get care from over 800 top-notch doctors, specialists and other providers at our 25 state-of-the-art medical offices conveniently located throughout metro Atlanta. You choose your own Primary Care Physician (PCP), who coordinates all of your care, like a TRICARE Prime PCM. You won’t need a referral for most specialty care. Most Kaiser Permanente medical offices also have lab, X-ray, and pharmacy services all under the same roof.

You’ll also have access to:

• a broad network of urgent care centers including three locations open 24/7
• hospital care at Emory Midtown, Emory Saint Joseph’s, Children’s HealthCare of Atlanta and others
• any ER for emergency care

Note: You’ll still be able to receive care at any military hospital or clinic if space is available.

If you are eligible for TRICARE Prime and:

• live in the metro Atlanta area (check ZIP Code below),
• are under the age of 65, and not entitled to Medicare Part A and B,
• do not have other health insurance,
• are not enrolled in TRICARE Reserve Select (TRS), TRICARE Retired Reserve (TRR), TRICARE Young Adult (TYA), or Continued Health Care Benefit Program (CHCBP),
• are not receiving services for an autism diagnosis, AND
• are a retiree, family member of a retiree, or an active duty family member,

you may be eligible to enroll in this option.

Note: Active duty service members and TRICARE Young Adult Prime beneficiaries are not eligible for Kaiser Permanente, a TRICARE Prime Option.

To verify eligibility, call Humana Military at 1-877-414-9950.

If you are 65 years or older, and have Medicare Parts A & B, you are covered under TRICARE For Life (TFL). Please see tricare.mil/tfl for detailed information.

A: Yes, retirees and family members of retirees who have TRICARE Prime pay an annual enrollment fee, which will also apply to this new TRICARE Prime option.

However for individuals who enroll in this plan, the enrollment fee will be waived for your first 12 months, as long as you remain enrolled during this time period.

This waiver will apply to any new enrollee who enrolls effective 2020, 2021, or 2022.

You can enroll:

• During TRICARE Open Season that occurs each fall, beginning on the Monday of the second full week in November to the Monday of the second full week in December.
• Up to 90 days after a Qualifying Life Event (QLE). external link such as marriage, the birth of a child, or retirement from active duty, etc.

A QLE for one family member means all family members may make enrollment changes.

Note: For recent retirees, you and your family members can enroll up to 12 months after your retirement date. However, we recommend enrolling as soon as possible to avoid a lapse in care or claims issues.

You can enroll by calling Humana Military at 1-877-414-9950.

With Kaiser Permanente, you’ll receive your healthcare within our facilities and network. You’ll continue your relationship with Humana Military for eligibility, enrollment, and benefits and claims administration. This allows you to take advantage of Kaiser Permanente’s extensive network and personalized, coordinated care model, along with Humana Military’s expertise in customer service and plan administration.

When you choose Kaiser Permanente’s TRICARE Prime option, you’ll receive all of the benefits offered by TRICARE Prime at the same cost-shares you currently pay in the TRICARE Prime program. In addition, you’ll benefit from the medical expertise, coordinated care, and convenience of getting care with Kaiser Permanente providers at no extra cost. You can also take advantage of discounts on chiropractic, acupuncture, massage therapy, gym memberships and health and fitness products.

As a Kaiser Permanente member, you’ll choose a Primary Care Physician (PCP) who will be your source for basic care, advice and direction. This is similar to a primary care manager (PCM) when you’re enrolled in TRICARE Prime. Care is provided by our network of over 800 top-notch providers at our 25 convenient medical offices in the metro Atlanta – most with lab and pharmacy – along with many urgent care centers and hospitals.

For specialty care received within a Kaiser Permanente facility, you won’t need a TRICARE referral or authorization. If your Kaiser Permanente provider refers you to a doctor within the Kaiser Permanente network, a referral will be submitted on your behalf. For most specialty care, there is no referral required.

Note: You’ll still be able to receive care at any military hospital or clinic, if space is available.

The Kaiser Permanente TRICARE Prime option offers virtually the same benefits as TRICARE Prime with these minimal variations. external link.

Yes. You have the option to receive care at a military hospital or clinic if space is available.

Yes, the Kaiser Permanente, a TRICARE Prime option includes a pharmacy program that:

• is part of your care, which makes medications more easily accessible
• has the same copayments as TRICARE Prime, and
• provides access to Kaiser Permanente’s extensive drug formulary. external link, which you can search by pressing “Ctrl” or “CMD” and “F” on your keyboard at the same time in the searchable PDF. (For questions about specific drug costs, call us at 1-877-904-0015.)

When you see a Kaiser Permanente doctor, you can usually pick up your prescriptions right in the same building on your way out the door.

Prescriptions are filled:

• On-site: At Kaiser Permanente pharmacies, which are conveniently located at our Kaiser Permanente facilities. After receiving care, your prescription can be picked up in the same facility before you leave. Our Comprehensive Medical Centers have extended and weekend hours.
• Through Mail Order: You can order your prescription refills from Kaiser Permanente online or by phone and have them sent to your door with no cost for shipping.
• One-Time Fill: If you need to fill a prescription after hours and there are no Kaiser Permanente pharmacies open at that time, you can go to any TRICARE network pharmacy. In that case, please contact your Kaiser Permanente PCP as soon as possible to determine if follow-up care or refills are needed.

Your PCP is a doctor who will be your source for basic care, advice and direction. This is similar to a primary care manager (PCM) with TRICARE Prime. Your PCP will coordinate your total care – from preventive checkups and routine medical care to specialized care and hospitalizations. You can choose your own PCP from the doctors at our Kaiser Permanente medical offices. You can change PCPs at any time.

No, you can choose a different PCP for each family member.

We have a large network of pediatricians for you to choose from for your children. Or, you can choose a family medicine physician as the PCP for you and your family.

You can learn more about our doctors at Meet Our Top Doctors or do an online search of our provider network. You can also get assistance with locating and choosing a PCP by calling us directly at 770-291-4430 or toll-free at 1-833-642-5973. Once you become a member, you can change your PCP at any time you need.

When you select a PCP, it is important to make an appointment to establish a relationship with your new doctor. This will allow your PCP to work with you on scheduling preventive services and any ongoing specialty care needed, ensuring a smooth transition and continuity of care.

You don’t need a referral to see most specialists within Kaiser Permanente. However, if you prefer, you can talk to your PCP so they can provide recommendations, guidance and follow-up care.

Kaiser Permanente provides coverage for urgent care services for non-emergency medical conditions requiring prompt attention-such as an ear infection or a sprained ankle. In metro Atlanta, you’ll have access to a broad network of urgent care locations. Three Kaiser Permanente locations offer urgent care 24/7.

• Gwinnett Comprehensive Medical Center. external link
  3650 Steve Reynolds Blvd.
  Duluth, GA 30096
• Southwood Comprehensive Medical Center. external link
  2470 Mt. Zion Parkway
  Jonesboro, GA 30236
• TownPark Comprehensive Medical Center. external link
  750 Townpark Lane
  Kennesaw, GA 30144

You can call us 24/7 to get nurse advice on the best way, and best location, to get the care you need at 770-291-4430 or toll-free at 1-833-642-5973.

You’ll have access to any hospital emergency room, anywhere you travel. In an emergency, which is a medical or psychiatric condition that requires immediate medical attention to prevent serious jeopardy to your health, you can call 911 or just go to the nearest hospital emergency room.

If you need hospital care such as a scheduled procedure or maternity care, Emory University Hospital Midtown and Emory Saint Joseph’s Hospital are the primary hospitals for Kaiser Permanente physicians and members. Children’s Healthcare of Atlanta is also an option. Northside Hospital is available for maternity care.

You’ll have coverage for emergency or urgent care anywhere you travel.

If you have a medical emergency¹, call 911 or go to the nearest hospital. If you’re admitted to a non-Kaiser Permanente hospital, we ask that you or the hospital contact us within 24 hours of admission to enable the coordination of your care.

If you have an urgent medical condition² that isn’t an emergency, you can visit any Kaiser Permanente facility that has urgent care or after-hours services (without a referral).³ Kaiser Permanente provides care in many states across the country including all or parts of California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, Washington, Washington, D.C. Call us 24/7, toll-free at 1-833-642-5973 to get nurse advice on the best way, and best location to get the care you need.

You’ll also have the choice of receiving care at a military hospital or clinic (if space is available). If a Kaiser Permanente facility or military hospital or clinic is not accessible, you can get urgent care from any TRICARE-authorized urgent care center or network provider without a referral.

To learn more, please see our Care Away from Home section.

 

¹An emergency medical condition is a medical or psychiatric condition that requires immediate medical attention to prevent serious jeopardy to your health.

²An urgent care need is one that requires prompt medical attention, usually within 24 or 48 hours, but is not an emergency medical condition. Examples include minor injuries, cuts, backaches, earaches, upper-respiratory symptoms, sore throats, frequent or severe coughs, frequent urination or a burning sensation when urinating.

³Please note that when you’re outside of Georgia, Kaiser Permanente urgent care contracted providers (those which are not inside a Kaiser Permanente facility) will be out of network unless they’re also TRICARE-authorized.

With Kaiser Permanente, a TRICARE Prime option, you’re covered when you’re away from home both in and outside the United States. Please see our Care Away from Home section to learn about your many care options.

You will need to contact Humana Military at 1-877-414-9950 to update your address.

If you’re still eligible for the Kaiser Permanente TRICARE Prime option, if you choose to, you can change your Primary Care Physician (PCP) at Kaiser Permanente by selecting a new PCP online or calling us at 770-291-4430 or toll-free at 1-833-642-5973.

Once you’re a member, if you move outside the service area, Humana Military can help you transition your care to TRICARE Prime or TRICARE Select at 1-877-414-9950.

The Kaiser Permanente, a TRICARE Prime option benefits and copayments are same as the TRICARE Prime benefits and copayments. You can view the TRICARE Prime benefits and copayments on tricare.mil/costs. external link . If you have specific questions about benefits and copayments, please contact Humana Military at 1-877-414-9950.

Our dedicated representatives are available at 1-877-904-0015 to answer your questions Monday through Friday from 8 a.m. to 6 p.m.

Once you’ve enrolled with Kaiser Permanente, you can get started in three simple steps. We have a dedicated team of representatives to walk you through. Just call 770-291-4430 or toll-free at 1-833-642-5973 and we’ll help.

• Step 1: Choose your doctorStart by selecting a primary care physician who’s right for you. You’ll choose from the top-notch doctors at Kaiser Permanente medical offices. Each covered family member can choose their own, and you can change your personal doctor any time.To choose your doctor, give us a call or browse our doctor profiles. If you call, go ahead and schedule your first doctor appointment so you can start building a relationship and get any preventive care you might need.
• Step 2: Get prescriptionsWe can help you transition your prescriptions to Kaiser Permanente—just have your current prescriptions handy. Call us or get started online. external link.
• Step 3: Register onlineOnce your coverage starts (this date can be found on your membership card), register on kp.org. external link or download the free Kaiser Permanente app. Then you can use time-saving features like emailing your doctor and refilling prescriptions.