Healthy together. See how our care and coverage can help you thrive

Transcription

1 Federal Employees and Annuitants 2017 Rates and Benefits Mid-Atlantic States Region Earn up to a $75 benefit in healthy rewards.4 This is an advertisement. Healthy together See how our care and coverage can help you thrive kp.org/feds Not a member yet? For more information, visit kp.org/feds or call (TTY: 711), Monday through Friday, 8 a.m. to 5 p.m. During open enrollment season, 8 a.m. to 10 p.m.

2 Kaiser Permanente Experience the Kaiser Permanente difference Choosing your doctor Choosing how you get care Making a routine appointment Getting medical advice With Kaiser Permanente 1 Learn about our doctors by reading their profiles and biographies on kp.org/ doctor, then choose the one who s right for you. How, when, and where do you want to receive care? From telephone advice to video visits, 1 in-person appointments to ing your doctor, and more, you re in control. Use your phone, computer, or mobile device anytime, anywhere. Get video medical advice with a doctor. 2 And specially trained Kaiser Permanente nurses give medical advice by phone, 24/7. Both have access to your health record and can make follow-up appointments. Without Kaiser Permanente You may not know much about a doctor. Or you may be offered a simple provider directory with minimal information. Even for minor concerns, you usually make an appointment, drive to the doctor s office, and sit in the waiting room. You ll likely have to call during business hours. If medical advice is available, the representative won t have access to your medical history and won t be able to connect you directly to care. In most of our facilities, you can Seeing your doctor, getting So much in see your doctor, get a lab a lab test, and picking one place test, and pick up prescriptions up medication probably under one roof. means 3 separate trips. Viewing your medical records and test results You and your providers have access to your electronic health record which includes your medical history and most test results keeping everyone connected and in the know. You have to collect or request all your medical records on your own, and your providers are not likely to be connected to each other. We have multilingual doctors Some health plans offer limited Getting care in and staff, and we offer access to interpreter services your language interpretation services by and multilingual doctors. phone in 150+ languages.

3 What s inside this booklet See how our care and coverage can help you thrive Check out everything that comes with your health plan, and see why more than 10 million people nationwide choose Kaiser Permanente. Get great care and the resources you need to live healthier all in one convenient package. A healthy partnership... P. 2 Great care, great results... P. 3 Benefit highlights... P. 10 Which option is right for you?... P. 11 Your 2017 benefits summary... P. 12 Care the way you want it... P. 4 Ready to enroll with Kaiser Permanente?... P. 13 Extras for your well-being... P. 5 Care for a range of needs... P. 6 Healthy resources... P. 7 Locations near you... P. 8 Once you join Visit kp.org/newmember to get started. It s easy to choose your doctor, register for kp.org, and transfer your prescriptions. If you have questions or need help making your first routine appointment, just give us a call. Already a member? Manage your care online at kp.org. If you haven t already, register at kp.org/registernow. Once you ve registered, you can your doctor s office with nonurgent questions, request routine appointments, order most prescription refills, and more. 1

4 Kaiser Permanente A healthy partnership Your Kaiser Permanente personal physician is the biggest advocate for your health. You choose your own doctor, and that doctor coordinates your care with specialists as needed. Choose your doctor and change anytime At kp.org/doctor, you can find information on a wide range of top-notch physicians, including their education, credentials, and specialties. You can choose your doctor from: Adult medicine/internal medicine Family medicine Pediatrics/family medicine (children up to 18) Select one doctor for your whole family or a different doctor for each family member. Quality care starts with quality doctors No matter which physician you choose, your health is in highly capable hands. Our doctors come from top medical schools, and many teach at world-renowned universities. Because we hire and train our own doctors, they are all held to the same quality standards and are committed to the same vision: Making your life better by being your trusted partners in total health. Culturally responsive care for diverse communities We believe nothing should stand between you and total health. That s why we provide care that s sensitive to the various ethnicities, cultural values, and languages of our members. To do this, we: Focus on hiring doctors and staff who speak more than one language Offer telephone interpretation services in more than 150 languages Train our providers in how to connect with, and care for, people of all backgrounds Coordinated and connected care Your doctor, nurses, and other caregivers work together as a team, sharing information to give you the care you need. They re connected to each other, and to you, through your electronic health record. They know your medical history, test results, medications, and allergies. So you get personalized care. Did you know? In 2015, Kaiser Permanente led the nation in 21 quality care measures, including controlling high blood pressure, managing diabetes, breast and colon cancer screening, and nutrition and exercise counseling for children. 3 To learn more, visit thrive.kp.org/quality. 2

5 Great care, great results See how our care and coverage can help you thrive Get the care you need to get and stay healthy. From preventive screenings to care for serious conditions, we ve got you covered. And your care is backed by cutting-edge research and advanced medical technology. Preventive care to keep you healthy Prevention plays a vital role in health care. That s why we offer so many resources to help you stay healthy and happy, and avoid getting sick. (For examples, see Healthy resources on page 7.) To catch problems early, we offer preventive screenings, routine appointments, and more. Your electronic health record is key, tracking the services you get and reminding you and your doctor when you re due for care. Comprehensive care when you need it Along with our commitment to prevention, we re here for you if you get sick. You get great doctors, state-of-the-art facilities, and the latest technology all combined to help you recover quickly. Advanced research working for you We re always looking to improve care for our members. Through our ongoing medical research, we discover new and better ways to prevent and treat illness. To make this work possible, we have: More than 4,500 studies underway 7 regional research centers and 1 national center More than 1,200 research staff members As one of the nation s largest research programs, we conduct and share our learnings from groundbreaking studies and clinical trials. Our areas of focus span a wide range of health issues, including cancer, heart disease, diabetes, childhood obesity, and autism. Learn more at share.kp.org/research. If you have a condition such as diabetes or heart disease, we ll work with you to manage it using proven best practices and treatment guidelines. Our well-rounded approach supports you physically and emotionally to help you continue living life to the fullest. Hear from members about their care experiences at kp.org/carestories. 3

6 Kaiser Permanente Care the way you want it How, when, and where do you want to receive care? How do you want to manage your health? When you get care in our facilities, you get what you need for the day and hour you need it. It s care that fits your life. Choose how you connect to care In person By phone By By video Because most of our locations offer many services under one roof, you can see your doctor, get lab services and X-rays, and pick up your prescriptions all in one trip. Where telephone appointments are available, you can save yourself a trip to the doctor s office and talk with your doctor by phone. And medical advice is always available by phone 24/7. You can your doctor s office with nonurgent questions and get a reply usually within 48 hours, often sooner. 1 Why not see your doctor by video and save the drive (and paying a share of the cost)? If you are 18 or older, and have a computer or mobile device with a built-in camera and microphone, you can meet with your personal doctor from home, work, or anywhere else. Your video visits are easy, secure, and part of your coordinated care. Need something sooner? Video visits are available with an emergency medicine physician from Kaiser Permanente who is connected to your doctor and your medical history. 2 Choose where you manage your care At home or work On the go Stay on top of your care 24/7 through My Health Manager at kp.org. If you receive care in Kaiser Permanente facilities, you can view your medical record, refill most prescriptions, schedule and cancel routine appointments, get vaccination records, see most lab results, and more. Visit kp.org/experience to see how it works. Wherever you are, you can access most of the features of My Health Manager on any mobile device through the KP app. You can also find a facility near you and get directions. Learn more at kp.org/mobile. To use the Kaiser Permanente app, you must be a Kaiser Permanente member registered on kp.org. 4

7 Extras for your well-being See how our care and coverage can help you thrive We care for the whole you. From emergencies to personal wellness goals, you get the support you need to thrive. And to sweeten the deal, we ll even throw in Visa reward cards just for taking healthy steps. Get coverage, no matter where life takes you As a Kaiser Permanente FEHB member, your benefits go further than your home service area. You re covered for emergency care anywhere in the world. We ll cover Urgent Care at non Kaiser Permanente facilities as long as it can t wait until you get back home. Just call our 24/7 Away from Home Travel Line at or visit kp.org/travel. You can receive care from Kaiser Permanente where our facilities are located in other areas of the country. Just call Member Services to check on what services are covered because plans in other areas vary. Students at school out of the service area can call Kaiser Permanente 24/7 for telephone medical advice. They are also covered for emergency care. If a follow-up appointment is needed after an emergency room visit, it s easy to get a referral for that appointment and any additional lab or imaging services. Help to quit smoking Let us help you succeed in quitting. You pay nothing for classes, telephone coaching, online programs, and prescriptions, including prescribed over-the-counter tobacco-cessation drugs. Ask your doctor about your treatment options. Earn healthy rewards Take steps to improve your well-being and earn up to $150 in rewards to pay for qualified medical expenses. 4 FEHB subscribers and their enrolled spouses (age 18 and over) are eligible for the following rewards: $50 for taking the Total Health Assessment, an online questionnaire that gives you a wellness action plan. $25 for completing a healthy lifestyle program, an online class to help you reach your health goals. Go to kp.org/feds to learn more and get started. 5

8 Kaiser Permanente Care for a range of needs Get the right care for any situation. We re just a call or a click away. Quality care, when and where you need it Emergency care If you need emergency care, you re covered worldwide anywhere, anytime. 5 Urgent Care Specialty care 24/7 nurse telephone advice Urgent Care services are located in many of our medical centers, and 6 are open 24/7 along with lab, X-ray, and pharmacy. Imagine the convenience of having the Urgent Care you need under one roof. Visit kp.org/urgentcare/mas for locations. Need to see a specialist? We have one of the largest multispecialty medical groups in the country, so you get access to the right specialist quickly. You don t need referrals for some care, including obstetrics-gynecology and behavioral health. Have questions? Not sure what kind of care you need? You can call our local and specially trained Kaiser Permanente advice nurses anytime. If you receive care in our facilities, the nurses are connected to your doctor, can see your health record and help figure out what type of care you may need, and even schedule a routine or Urgent Care appointment for you. Physician video advice When you call for medical advice, you may be able to visit with an emergency medicine physician from Kaiser Permanente via video. Our advice doctors are connected to your personal doctor and your medical history. 2 Care away from home Hospital care If you get sick or injured while you re away from home, we can help you get care. We can also help you prepare for travel by checking if you need a vaccination, getting you a prescription refill before you leave, and more. Just call our 24/7 Away from Home Travel Line at or visit kp.org/travel. 6 (International calls are not toll-free.) We believe you deserve the best care at all times. And that s never more important than when you need a hospital. We carefully select premier hospitals to partner with us in taking great care of you. Find out who they are and why we believe their care is better. Visit kp.org/premierhospitals. 6

9 Healthy resources See how our care and coverage can help you thrive Good health goes beyond the doctor s office. Take a look at all the healthy tools and resources available online, by phone, and at our facilities and choose the ones that work for you. Get the most out of your health plan Online wellness tools Visit kp.org/healthyliving for helpful articles, wellness information, health calculators, fitness videos, music channels, podcasts, and recipes from world-class chefs. Healthy lifestyle programs Connect to better health. Our online programs can help you lose weight, quit smoking, reduce stress, sleep better, and more all at no cost. Learn more at kp.org/healthylifestyles. On-site health classes Choose from a large variety of classes and support groups and get help improving your health. Find classes near you at kp.org/classes. Some classes may require a fee. Personal wellness coaching Work one-on-one by phone with a personal wellness coach at no cost. You can get help and inspiration for reaching a variety of health goals. Find out more at kp.org/wellnesscoach. Reduced rates for members Our members get special rates on a variety of health-related products and services like gym memberships, massage therapy, and more. Check out your options at kp.org/choosehealthy. Seasonal farmers markets Enjoy shopping for fresh, local produce and much more at our farmers markets hosted at some of our facilities. If food is your thing, visit kp.org/foodforhealth. Services are offered by entities other than Kaiser Permanente and are not offered or guaranteed under any contract. Kaiser Permanente isn t liable for services provided by the entities. Services can be changed or discontinued at any time. 7

10 Kaiser Permanente Locations near you It s easy to get the care you and your family need. There are many Kaiser Permanente facilities in your area, offering convenient hours and a wide range of care and services. Easy access for easier care With convenient hours and locations, it s simple to get the care you and your family need. Many of our locations offer same-day, next-day, afterhours, and weekend services. Most of our facilities offer a variety of care and services, so you can manage several health care needs in one visit. You can see your doctor or specialist, get a lab test or an X-ray, and pick up your medications all without leaving the building. Getting care anywhere With so many locations to choose from, you re sure to find one near your home or work whatever s best for you. You can also see different doctors at different locations, either for yourself or your family. For example, you can choose a personal doctor close to work and an optometrist close to home, and your child can see a pediatrician near school. Finding convenient locations Choosing the right location is as easy as hopping online or pulling out your smartphone. Visit kp.org/kpfacilities to search by ZIP code, keyword, or the service you want. Online tours of each of our medical centers See each of the places where we care for our members, from the front door to the pharmacy, from the exam rooms to the lab, from physical therapy to where we perform MRIs, and every place in between. You can choose to look at still photos or 360 o guided photo tours. Visit kp.org/midatlantic. New medical centers opening spring 2017! Our Severna Park Medical Center will relocate to Glen Burnie and be named North Arundel Medical Center. And look for a new medical center in Harford County, also in spring Locations on the next page Did you know? We feature more than 500 seasonal, doctor-recommended recipes on our Food for Health blog. Get inspired at kp.org/recipes. 8

11 See how our care and coverage can help you thrive Kaiser Permanente medical facilities Maryland Washington, DC 1 Annapolis Medical Center 30 Kaiser Permanente Capitol Hill Medical Center 2 Camp Springs Medical Center 31 Northwest DC Medical Office Building 3 Kaiser Permanente Baltimore Harbor Medical Center 4 Columbia Gateway Medical Center 83 5 Kaiser Permanente Frederick Carroll Harford Medical Center Baltimore 19 6 Gaithersburg Medical Center 16 7 Kensington Medical Center Frederick MD Largo Medical Center Balt City 70 9 Marlow Heights Medical Center Howard 10 NEW! North Arundel Medical Center 15 Opening spring Montgomery Prince George s Medical Center Loudoun Severna Park Medical Center Anne Arundel Relocating spring Shady Grove Medical Center DC 14 Silver Spring Medical Center South Baltimore County 9 66 Medical Center Fairfax Prince George s 16 Towson Medical Center 17 White Marsh Medical Center Woodlawn Medical Center Prince William Calvert Fauquier NEW! Medical Center in Harford County Charles Opening spring 2017 Virginia 20 Ashburn Medical Center 21 Burke Medical Center 22 Fair Oaks Medical Center 23 Falls Church Medical Center 24 Fredericksburg Medical Center 25 Manassas Medical Center 26 Reston Medical Center 27 Springfield Medical Center 28 Tysons Corner Medical Center 29 Woodbridge Medical Center Orange Culpeper Louisa Spotsylvania 25 VA Stafford City of Fredericksburg Hanover Caroline King George Westmoreland These These centers offer 24/7: Urgent Care Lab Lab Pharmacy Pharmacy Radiology Radiology Not available for Medicare for Medicare Plus enrollees. Plus enrollees. Please check kp.org/facilities for the most up-to-date listing of the services located at Kaiser Permanente medical centers, or call Member Services. All Severna Park services and providers will relocate to the new North Arundel Medical Center in spring

12 Kaiser Permanente 2017 Benefit highlights $0 copayments for dependents Families choosing the Standard Plan can now save more with $0 copays for dependents through age 17. Reduced prescription copays Save money on copays for a 30-day supply of generic medicines, reduced from $12 to $10 on the Standard Plan. The mail service delivery program will apply two copayments for up to a 90-day supply. Take advantage of chiropractic and acupuncture services You can receive up to 20 chiropractic visits per year for the diagnosis and treatment of neuromusculoskeletal disorders and up to 20 acupuncture visits per year to diagnose and treat chronic pain and nausea when referred by your plan physician. You pay $20 per visit (High Option) and $30 per visit (Standard Option). Preventive dental care included With an emphasis on prevention and early detection of dental problems, your dental benefit can help you maintain good oral health and avoid costly procedures in the future. You pay just $30 per visit for diagnostic and preventive dental services, which include oral evaluation, cleaning, and certain X-rays. Other covered dental services are provided at a reduced fee. You must receive all your care from participating Dominion National dental providers. To learn more, call Dominion member services specialists at , Monday through Friday, 7:30 a.m. to 6 p.m. For TTY for hearing/speech impaired, call 711. Or visit dominiondental.com/kaiserdentists. Other benefit changes Key benefit changes to High and Standard Options include: A $0 copay for specialist consultation prior to preventive colonoscopy applies to both the Standard and High Option plans. Benefits added for Applied Behavioral Analysis (ABA) for children through the end of the month they turn 19, who have Autism Spectrum Disorder diagnosis. Copay is same as PCP ($10 for High Option, $20 on Standard Option plans.) We have increased your copayment for emergency services from $125 to $150. We have removed coverage for in vitro fertilization. Rewards program Visa card is changing to a health payment card for qualified medical expenses. 4 We increased coverage for rehabilitation and habilitative therapy by separating visit limits. To learn more, see the 2017 benefits summary on page 12; download our Federal Employees Health Benefits (FEHB) brochure, FEHB formulary (list of covered drugs), and other material at kp.org/feds; or call us at (TTY 711), Monday through Friday, 8 a.m. to 5 p.m. You can also fill out the reply card at the back of this brochure to get material. Eyewear benefits Whether you choose the High or Standard Option of care, you pay 75 percent of our allowance for eyeglass frames, lenses, and a total contact lens package at Kaiser Permanente optical centers. 10

13 See how our care and coverage can help you thrive Which option is right for you? High Option Standard Option Included with Both Options Higher premiums, with lower copays for most services and prescription drugs If you want low out-ofpocket costs, this may be the right choice. Lower premiums, but higher copays for most services and prescription drugs If you want predictable copays at a lower premium, or if you have children under age 18, this may be the right choice. No copays for Most preventive care ing your doctor s office Video appointments with your personal care physician (PCP) 2 Video medical advice with a doctor 2 No deductible $30 preventive care dental benefit Eyewear coverage No paperwork or bills when you get care in Kaiser Permanente facilities Covered for emergency care worldwide Access to a range of health and wellness classes at Kaiser Permanente medical centers and online, most at no cost Our Medicare health plan members get better benefits If you have Medicare and decide to enroll in Kaiser Permanente Medicare Plus (Cost) for Federal members, you ll get richer benefits than with your FEHB coverage alone. Learn all about the different parts of Medicare and how they work together in Your Guide to Choosing a Kaiser Permanente Medicare Health Plan. Download our brochure at kp.org/feds, or to have one sent to you, please call Member Services at (TTY 711), 7 days a week, 8 a.m. to 8 p.m. Discounts and savings for additional health care services ChooseHealthy You ll receive discounts off regular rates for services such as massage therapy and acupuncture, and get preferred rates on select fitness club memberships. 7 You ll also get no-cost shipping on purchases of vitamins and herbal supplements. To learn more, go to the Health & Wellness section of kp.org or call

14 Kaiser Permanente Your 2017 benefits summary 12 Benefits and Services High Option Standard Option Outpatient services (per visit or procedure) Preventive care $0 $0 Primary care $10/$0 through age 4 $20 adult / $0 through age 17 Specialty care $20 $30 Lab tests and X-rays $0 $0 Specialty scans $75 $100 Chiropractic services (up to 20 visits per year) $20 $30 Hospital and facility Outpatient surgery $75 $150 Inpatient hospital care (per admission) $100 $250 per day up to $750 Maternity Routine prenatal care visit, first postpartum visit $0 $0 Delivery (per admission) $100 $250 per day up to $750 Emergency and Urgent Care (per visit or trip) Emergency care $100 $150 Urgent Care $20 $30 Ambulance $0 $100 Prescription drugs (up to a 30-day supply at plan pharmacies. See page 8 for mail-order discounts.) 8 Generic $7 $10 Preferred brand $30 $35 Non-preferred brand $45 $65 Specialty 20% up to $100 30% up to $150 Out-of-pocket maximum (2x per family maximum) $2,250 per person $3,500 per person Your Premium Share 9 High Option Standard Option Biweekly Non-Postal $74.50 $55.85 Self Biweekly Postal Category 1 $65.27 $48.59 Only Biweekly Postal Category 2 $62.19 $46.36 Monthly Non-Postal $ $ Biweekly Non-Postal $ $ Self Biweekly Postal Category 1 $ $ Plus One Biweekly Postal Category 2 $ $ Monthly Non-Postal $ $ Biweekly Non-Postal $ $ Self Biweekly Postal Category 1 $ $ and Family Biweekly Postal Category 2 $ $ Monthly Non-Postal $ $283.16

15 See how our care and coverage can help you thrive Ready to enroll with Kaiser Permanente? 1. Choose an option. 2. Select the type of enrollment you want. 3. Sign up online or call. High Option Standard Option Find brief descriptions of these options on page 11. More details about benefits and rates are on page 12. Self Only covers you. Self Plus One covers you and one eligible family member. Self and Family covers you and all eligible family members. Find your enrollment code in the chart below. Then, visit opm.gov to enroll online or contact your employing agency or retirement office for next steps and other information. Annuitants can contact the Retirement Information Center at or (TTY), or If you qualify for Medicare, or will soon, see page 11 for more information. Self Plus One Self Plus One is available for enrollees to cover themselves and one eligible dependent. Or, you may choose to enroll in Self and Family. You decide which enrollment type is best for you. If you choose the High Option, you will pay a lower premium if you enroll in Self and Family. If you choose the Standard Option, you will pay a lower premium if you enroll in Self Plus One. All FEHB enrollees can make enrollment changes during Open Season, when you experience a qualifying event, or during a Special Enrollment. If you are a retiree, you have the additional option to decrease your enrollment type throughout the year. To move from Self and Family to Self Plus One, you must change your enrollment by following Step 3 above. Choose the right enrollment code Enrollment Code High Option Standard Option Self Only E31 E34 Self Plus One E33 E36 Self and Family E32 E35 Need help? Call us at (TTY 711), Monday through Friday, 8 a.m. to 5 p.m. These are highlights of the FEHB enrollment process. Please refer directly to opm.gov and your employing agency or retirement office for FEHB coverage effective dates, enrollment procedures and deadlines, and other information. To add an eligible family member to your Kaiser Permanente Self and Family, complete and return an Enrollment Change Form to us. These forms can be obtained at kp.org/feds or by calling Member Services. 13

16 The right choice for a healthier you Having a good health plan is important. So is getting quality care. With Kaiser Permanente, you get both. Learn more about how health care and coverage work together, for you. Member Services (TTY 711) Monday through Friday, 8 a.m. to 5 p.m. kp.org/feds Stay connected to good health

17 End notes: 1 These features are available when you get care at Kaiser Permanente facilities. ² Video appointments with primary care physicians (PCPs) available only with Permanente physicians. During a PCP visit, you must be present in Maryland, Virginia, or Washington, DC. For urgent medical advice video visits, you may also be located in Florida, North Carolina, West Virginia, or Pennsylvania. For members 18 and older. For certain medical conditions. ³ Kaiser Permanente 2015 HEDIS scores. Benchmarks provided by the National Committee for Quality Assurance (NCQA) Quality Compass and represent all lines of business. Kaiser Permanente combined region scores were provided by the Kaiser Permanente Department of Care and Service Quality. The source for data contained in this publication is Quality Compass 2015 and is used with the permission of NCQA. Quality Compass 2015 includes certain CAHPS data. Any data display, analysis, interpretation, or conclusion based on these data is solely that of the authors, and NCQA specifically disclaims responsibility for any such display, analysis, interpretation, or conclusion. Quality Compass and HEDIS are registered trademarks of NCQA. CAHPS is a registered trademark of the Agency for Healthcare Research and Quality. 4 The rewards program runs from January 1 through December 31, 2017, and is open to all Kaiser Permanente FEHB subscribers and their enrolled spouses 18 and older. You can take the Total Health Assessment as often as you like and as many healthy lifestyle programs as you want, but you can only earn rewards for them once during the reward period. You must complete the activities during the calendar year. Reward cards expire 12 months from the date issued. We will send each eligible member a Kaiser Permanente Health Payment Card 4 6 weeks after you complete your first activity, then load additional rewards when you complete your second activity. You must keep your card for use throughout the year and use rewards you earn to pay qualified medical expenses by March 31 of the next calendar year. Go to kp.org/feds to learn more and get started. 5 If you reasonably believe you have an emergency medical condition, which is a medical or psychiatric condition that requires immediate medical attention to prevent serious jeopardy to your health, call 911 or go to the nearest emergency department. For the complete definition of an emergency medical condition, please refer to your Evidence of Coverage. 6 This number can be dialed from inside and outside the United States. Outside, you must dial the U.S. country code 001 for land lines and +1 for mobile before the phone number. Long-distance charges may apply and we cannot accept collect calls. This phone line is closed on major holidays. 7 This value-added service is an extra service provided by entities other than Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. (KFHP-MAS), and is neither offered nor guaranteed under any KFHP-MAS contract. This entity may change or discontinue offering this service at any time. KFHP-MAS disclaims any liability for the service provided by this entity. 8 Plan providers determine the drug that is medically necessary. If you request another drug, you pay prices charged to members for non-covered drugs. 9 These rates do not apply to all enrollees. If you are in a special enrollment category, please contact the agency or Tribal Employer which maintains your health benefits enrollment.

18 the card and drop it in the mail. There is no fee for postage. Seal off the card and fold it with your information inside. Tear out your information and choose the materials you d like to receive. Fill Use this reply card to get more information about the Kaiser Permanente health coverage available through the Federal Employees Health Benefits (FEHB) Program E. Jefferson St. Rockville, MD MAS 10/1/16-12/31/17 Federal Employees and Annuitants 2017 Rates and Benefits Mid-Atlantic States Region Earn up to a $75 benefit in healthy rewards.4 This is an advertisement. Healthy together See how our care and coverage can help you thrive This is a summary of the features of the Kaiser Permanente health plan. Before making a final decision, please read the plan s federal brochure (RI ). All benefits are subject to the definitions, limitations, and exclusions set forth in the federal brochure. The benefits listed on page 7 ( Healthy resources, except Health classes ) and on page 11 (discounts and savings for additional health care services) are neither offered nor guaranteed under contract with the Federal Employees Health Benefits (FEHB) Program, but are made available to all enrollees and family members who become members of Kaiser Permanente. Kaiser Permanente Medicare Plus for Federal Members Kaiser Permanente is a Cost plan with a Medicare contract. Enrollment in Kaiser Permanente depends on contract renewal. To join a Kaiser Permanente Medicare health plan, you must reside in the Kaiser Permanente Medicare Plus service area in which you enroll. Benefits, premiums and/or copayments/ coinsurance may change on January 1 of each year and at other times in accord with your group s contract with us. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. You must pay the Medicare Part Bpremium to join a Kaiser Permanente Medicare health plan. Enrolling in Medicare Plus for Federal Members will not affect the benefits you receive through the Federal Employees Health Benefits (FEHB) Program, although the network and other rules of Medicare may apply. ATTN: ART & NEGATIVE SUITE BOSTON WAY LANHAM MD FIRST-CLASS MAIL PERMIT NO LANHAM, MD Want to know more? Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. Notice of Summary of Benefits and Coverage (SBC): Availability of Summary Health Information The FEHB Program offers numerous health benefits plans and coverage options. Choosing a health plan and coverage option is an important decision. To help you make an informed choice, each FEHB plan makes available an SBC about each of its health coverage options, online and in paper. The SBC summarizes important information in a standard format to help you compare plans and options. This plan s SBC is available on the Internet at kp.org/feds. A paper copy is also available, free of charge, by calling For TTY for the deaf, hard of hearing, or speech-impaired, call 711. To find out more information about plans available under the FEHB Program, including SBCs for other FEHB plans, please visit opm.gov. kp.org/feds Not a member yet? 2016 Kaiser Foundation Health Plan, Inc. For more information, visit kp.org/feds or call (TTY: 711), Monday through Friday, 8 a.m. to 5 p.m. During open enrollment season, 8 a.m. to 10 p.m.