3 years, 3 months ago
Will I still be covered by Kaiser Permanente if elect Cobra and move to Florida where Kaiser doesn't have offices?
My Company use Kaiser Permanente Health Care. If I quit my job, elect to go on Cobra and then move to Florida where there are no Kaiser's will I still be covered? If I am covered in what way will I be covered since I'll then be out of Kaiser's network. Just FYI with Kaiser we have to see Kaiser doctors and buy our meds from Kaiser pharmacies.
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M$1 Answer
Kaiser Permanente has a strategic alliance with AvMed Health Plan, who serve Florida. In any case, Kaiser will cover you, BUT,
If you go to any doctor in Florida, you will have to pay a greater share of the cost, including an annual deductible and higher coinsurance, as you will be using out-of-network care.
When members receive out-of-network care from community providers, they may visit any qualified doctor, allied health professional, or hospital covered under the service agreement. However, members will pay a greater share of the cost, including an annual deductible and higher coinsurance, than they would pay when using in-network care or with the preferred provider organization (PPO) option.
If the provider does not bill, members must file claims for reimbursement and may be charged for any difference between the billed cost and the "usual and customary" cost of treatment. Members must also receive prior authorization review (PAR) for most services.
If you go to any doctor in Florida, you will have to pay a greater share of the cost, including an annual deductible and higher coinsurance, as you will be using out-of-network care.
When members receive out-of-network care from community providers, they may visit any qualified doctor, allied health professional, or hospital covered under the service agreement. However, members will pay a greater share of the cost, including an annual deductible and higher coinsurance, than they would pay when using in-network care or with the preferred provider organization (PPO) option.
If the provider does not bill, members must file claims for reimbursement and may be charged for any difference between the billed cost and the "usual and customary" cost of treatment. Members must also receive prior authorization review (PAR) for most services.
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M$
kaiser has several plans. It depends, on your particular policy.
Sometimes, buying a new policy will be cheaper than what you have to pay for COBRA coverage. You can even consider high deductible plans, where the monthly premiums are low.
According to my plan it says, Out of Network Care Covered: Only for Emergency Care. It also says "Plan is available only in the following areas" and they are all Colorado areas. Does the AvMed Health Plan still apply?