Your partner in good health

test results online

I can email my doctor

free to focus on you

I’m part of the decision

a wide range of specialists

better care for healthier tomorrows

convenient facilities near you

I can choose and change my doctor anytime

Statements above relate to Kaiser Permanente physicians and services only.

State of Maryland Employee and Retiree Health and Welfare Benefits Program

Kaiser Permanente Integrated Health Model Plan

2015 Enrollment Book

State of Maryland: Discover the Kaiser Permanente difference

With care and coverage working seamlessly together, Kaiser Permanente is uniquely designed to be your partner in health so you can feel your best—in mind, body, and spirit.

Note: Many features discussed in this book are available only to members receiving care at Kaiser Permanente medical facilities.

my.kp.org/maryland

healthy extrasStay at your best with resources like wellness classes, coaching for chronic conditions, farmers markets, and more.

healthier tomorrows Every decision starts with what’s best for you. That’s why our high-quality care for conditions like cancer, heart disease, and diabetes leads to better outcomes and healthier tomorrows.

everything under one roofYou can do more and drive less because most of our locations include pharmacy, lab, X-ray services, and more.

your choice of top doctorsYou can choose and change your doctor anytime, for any reason. Our doctors are among the best. They love caring for people and aren’t weighed down by a lot of paperwork, so they can focus on you.

online access anytime, anywhere It’s easy to stay involved in your care. Use your computer or mobile device to email your doctor’s office, schedule routine appointments, view most lab test results, refill most prescriptions, and more.

personalized care and attentionYou’re at the center of your care. Your doctors, nurses, and specialists, all connected by your electronic health record, work together to help you manage your health.

1

Kaiser Permanente A better choice for good health

Your partner in good healthNationwide, more than 9 million people turn to us as their trusted partner in total health. Take a look, and you’ll see why Kaiser Permanente is a better choice for the State of Maryland.

The power to choose ..............................................................2

Excellent care .........................................................................3

Your health. Your way. ............................................................4

Healthy extras ........................................................................5

Experience the Kaiser Permanente difference ........................6

Our locations ..........................................................................7

Footnotes ...............................................................................8

Prefer to see this information online? Go to my.kp.org/maryland.

For more information on rates and benefits, visit www.dbm.maryland.gov/benefits.

The power to choose

Stay in charge of your health. It’s simple to make smart choices when you have great doctors and convenient facilities.

Excellent care

At Kaiser Permanente you have access to the region’s #1 ranked health plan. It includes some of the Mid-Atlantic’s top specialists in cardiology, oncology, ob/gyn, and more.2,8

Learn more about the doctors available in your area at kp.org/doctorsandlocations.

Your doctor’s officeYour personal electronic medical record gets updated with each visit to a Kaiser Permanente facility, so it’s current.

Pharmacy,4 lab, X-rayNo need for paperwork when you get services at our facilities—your doctor’s orders are already there.

Your electronic health record brings it all together.

Specialty careYour specialist sees the same information as your primary care doctor, pharmacist, and other members of your care team—so they’re up to speed and ready to take care of you.

At home or on the goGet your health information on your computer or mobile device to stay informed and in charge.

Our members say it best. Hear their stories at kp.org/carestories.

Personalized care and attention

Your care is personalized and designed to fit your life. Kaiser Permanente’s care teams are connected to you and to one another and have access to your medical records. Your team works together to provide care that leads to better health. And it doesn’t stop there. You have access to no-cost online and mobile wellness tools, telephone coaching on stress management and smoking cessation, and much more.

Easy access to top specialty care

Seeing specialists who are experts in their fields just got easier.

At Kaiser Permanente, your primary care doctor can book an appointment for you to see a specialist, sometimes on the same day. You get the care you need faster and easier. Since your doctors are connected electronically, your records and other information are instantly available to the specialists.

Leaders in prevention and chronic disease5

We’re committed to preventative care and your overall wellness. We are among the best in treatments for those with chronic diseases.

We keep our members healthy with easy access to wellness tools, routine appointments, and preventive care screenings. In fact, Kaiser Permanente is ranked first in the nation in breast cancer screenings. We are first in the Mid-Atlantic region in cholesterol management of patients with cardiovascular conditions, in cervical cancer screenings, and in childhood immunizations.5

Your choice of top doctors1,2

You have a wide selection of skilled doctors that you can choose from and change anytime, for any reason.

Our doctors: g Come from many of the top medical schools in the country

g Work hand in hand with your entire care team, who are all connected by your electronic health record

g Don’t have excessive paperwork so they can focus on delivering the care you need

g Care about their patients and love what they do

Under-one-roof access

Save time and avoid driving all over town for care. You’ll have many locations to choose from, and most of them offer multiple services under one roof. You can see your doctor, get a lab test or an X-ray, and pick up medications, for members enrolled in the State of Maryland Express Scripts pharmacy plan all without leaving the building.

Urgent care services are located in ten Mid-Atlantic Kaiser Permanente medical centers, five of which have 24/7 urgent care, pharmacy,4 lab, and advanced imaging.

Extra conveniences

g Email your doctor’s office with routine questions.

g Get same-day, after-hours, and weekend services at multiple locations.

g It’s easy to find doctors who speak more than one language.

g For members enrolled in the State of Maryland Express Scripts pharmacy plan, you can refill prescriptions online, by telephone, or mobile app.

g Call our 24/7 medical advice line to talk with a nurse or video chat with a doctor.3

g Travel freely; you’re covered for emergency care worldwide.

2 3

For a guided tour of My Health Manager, visit kp.org/experience. Find tools, tips, and information for living well at kp.org/livehealthy.

Your health. Your way.

We’re always here when you need us, however you need us. You can get many services under one roof at most of our locations and call our medical advice line 24/7. You can manage your family’s health needs anytime, anywhere, online or through mobile.

It’s easy to stay connected

Members registered on kp.org have secure access to My Health Manager, the online tool that helps you manage your family’s health care anytime, anywhere.

With My Health Manager, you can:g Email your doctor’s office with routine questions.

g Refill most prescriptions for members enrolled in the State of Maryland Express Scripts pharmacy plan.

g View most lab test results.g Make, change, or cancel routine appointments.

A website full of healthy ideas

Get informed and inspired on our award-winning website, kp.org. Take charge of your health with articles, wellness topics, and health calculators. Our music channels, podcasts, fitness videos, and recipes from world-class chefs can help you find new and interesting ways to live well and thrive.

Good health on the go

Manage your care from home, work, or on the go with our mobile app, which puts all the convenient features of My Health Manager right in the palm of your hand. You can download the free Kaiser Permanente app from the App StoreSM or Google Play®.

Healthy extras

Good health starts with helpful information and resources. That’s why you get lots of healthy extras as a Kaiser Permanente member.

Learn something new

Fit wellness into your schedule, no matter how busy you are. With the many health classes we offer, there’s something for everyone. Try classes for eating well, baby care, ongoing health conditions, and much more. Classes vary by location and some may require a fee.

Fresh food in the parking lot

Eating well is easier when you bring home fresh food from our farmers markets. They’re conveniently located at many of our facilities, so you can pick up fresh fruits and delicious vegetables when you’re in the neighborhood.

Maximize your health

Our personalized online wellness programs can help you lose weight, stay active, reduce stress, sleep better, and much more.5 You can also download the free Every Body Walk! app for your smartphone or mobile device from the App Store or Google Play. It’s a fun, interactive tool to help you create and maintain a daily walking routine.

You can chooseand change your doctor anytime, for any reason.

Excellent care,for conditions like cancer, heart disease, and diabetes, leads to healthier tomorrows.

Top reasons to join Kaiser Permanente

Under-one-roof convenience, and care online or by phone, means you can manage your health needs anytime, anywhere.

Healthy extraslike on-site classes* and farmers markets help you stay well.

App Store is a service mark of Apple, Inc., and Google Play is a trademark of Google, Inc.

* Some classes may require a fee.

4 5

App Store is a service mark of Apple, Inc., and Google Play is a trademark of Google, Inc.

6 7

Need to talk to a live person? Call Member Services, 7 days a week, 7 a.m. to 11 p.m., at 855-839-5763 or 711 TTY for hearing impaired.

2015 State of Maryland Kaiser Permanente IHM Benefit Highlights6

Benefits and services

Preventive care

Routine physical exam $0

Outpatient services (per visit or procedure)

Primary care office visit (copay waived for children under age 5)

$15

Specialty care office visit $15

Most X-rays and lab tests $0

MRI, CT, PET scans $0

Outpatient surgery $0

Chiropractic and acupuncture services $15

Inpatient hospital careRoom and board, surgery, anesthesia, X-rays, lab tests, medications $0 per admission

Maternity

Routine prenatal care visits and first postpartum visit $0

$0

$0

Delivery $0 per admission

Telemedicine

In office e-consult with specialist

Video chat with a doctor 3

Emergency and urgent care (per visit or trip)

Emergency care7 $150

Urgent care $15

Ambulance $0

Prescription drugs Generic/brand

Prescription drug coverage Not covered under medical plan

Maximum out-of-pocket Per person $1,500

Maximum per family $3,000

Our locations and hospital partners*

Care is convenient and connected with 29 locations in the Mid-Atlantic region. Ten locations provide urgent care services and five provide 24/7 services including urgent care, pharmacy, lab, and advanced imaging. Why drive around town for all your health care needs when what you need is in the same building?

Visit us at my.kp.org/maryland to connect to a facility, review physician profiles or directories, and learn more about Kaiser Permanente services.

For more information on rates and benefits, visit www.dbm.maryland.gov/benefits.

Maryland Annapolis

Camp Springs UC

City Plaza

Columbia Gateway

Kaiser Permanente Frederick

Gaithersburg 24/7

Greater Baltimore Medical Center H

Holy Cross Hospital H

Kensington UC

Largo 24/7

Marlow Heights

Prince George’s

Severna Park

Shady Grove

Sibley Memorial Hospital H

Silver Spring

South Baltimore County 24/7

St. Agnes Hospital H

Suburban Hospital H

Summit Behavioral Health Center

Towson

White Marsh UC

Woodlawn

Virginia Ashburn

Burke

Fair Oaks

Falls Church

Fredericksburg (not available for Medicare Plus enrollees)

Manassas

Reston UC

Reston Hospital Center H

Springfield

Stafford Hospital H

Tysons Corner 24/7

Virginia Hospital Center H

Woodbridge UC

Washington, D.C. Kaiser Permanente Capitol Hill 24/7

Children’s National Medical Center H

Northwest D.C. Medical Office Building

Washington Hospital Center H

* Hospitals are independently owned and operated and are not affiliated entities of Kaiser Permanente.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40

Charles

Calvert

Prince George’s

Montgomery

Frederick Carroll

Howard

Baltimore

Anne Arundel

Balt. City

95695

4070

9795 295

50

270

VA

1

20

MD2

3

4

5

9

10

11

12

1314

16

21

22

23

6

17

95

95

50

267

66

495

Loudoun

Fairfax

Prince William

Stafford

King GeorgeCity of

Fredericksburg

Fauquier

Culpeper

24

26

2925

32

27

28

30

36

33

DC39

34 37

31

7

8

15

18

19

35

3840

UC: Medical center with urgent care

24/7: Urgent care, pharmacy, laboratory, and radiology

H: Hospital partners

1 To nominate a physician to join the Mid-Atlantic Permanente Medical group, please call the State of Maryland dedicated member services line at 855-839-5763, 7 days a week, 7 a.m. to 11 p.m.

2 315 of our doctors are named in the 2013–2014 “Top Doctors” editions of Washingtonian Magazine (March, 2014), Northern Virginia Magazine (February, 2014), Baltimore Magazine (November, 2013), and are recognized as “Super Doctors” in Washington Post magazine (October, 2013).

3Video chat is only available for certain medical conditions.

4 Only members that are enrolled in the State of Maryland Express Scripts pharmacy plan can use Kaiser Permanente pharmacies to fill and refill prescriptions.

5 Ratings based on breast cancer screening, cervical cancer screening, colorectal cancer screening, and controlling high blood pressure. 2012 ratings for commercial and Medicare plans from the Healthcare Effectiveness Data and Information Set (HEDIS) published by the National Committee for Quality Assurance. For more information, visit ncqa.org.

6 This is a summary of the benefits of the Kaiser Permanente Integrated Health Model plan. Before making a final decision, please read the State of Maryland Summary of Benefits and Coverage as additional exclusions and limitations may apply. This document can be downloaded by visiting the plans and benefits section of my.kp.org/maryland or by calling 855-839-5763.

7 The emergency copay is waived if admitted to the hospital within 24 hours for the same condition or if admitted directly to the hospital as an inpatient.

8 In NCQA’s Health Insurance Plan Rankings 2013-2014, Kaiser Permanente of the Mid-Atlantic States ranked 16 out of 484 Commercial health plans in the country, highest in MD, VA, and D.C.

Footnotes

8

Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.2101 East Jefferson Street, Rockville, MD 20852 141284_OE SOM Enroll_LgN_br 9/15/14–12/31/15

my.kp.org/maryland