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Summary Plan Description (SPD)
Kaiser HMO Medical Plan
In This Section:
- Summary of Benefits
- Chiropractic
- Basic Information
- Definition of Dependents
- In Case of an Emergency
- Online Internet Website – Kaiser
- Kaiser Medical Care That Is Not Covered
- Continuation of Group Coverage under Federal or State Law
- Coordination of Benefits By Kaiser
- Extension of Benefits
- Third Party Liability
This section modified by: Amendment 35. View Previous Language
- This benefit chart is a summary only. It does not fully describe your benefit coverage. For details on your benefit coverage, please refer to Kaiser Foundation Health Plan, Inc., Evidence of Coverage. The Evidence of Coverage is the binding document between Health Plan and its members.
- A Health Plan physician must determine that the services and supplies are medically necessary to prevent, diagnose, or treat your medical condition. The services and supplies must be provided, prescribed, authorized, or directed by a Health Plan physician. You must receive the services and supplies at a Health Plan facility or skilled nursing facility inside our Service area, except where specifically noted to the contrary in the Evidence of Coverage.
- For details on the benefit and claims review and adjudication procedures, please refer to Kaiser Health Plan’s Evidence of Coverage or contact Kaiser Membership Services at 1(800) 464-4000.