Perhaps you’ve been waiting a while and you want to know the status of your Kaiser Permanente Application for Individual and Family health insurance coverage. Applications have been taking on average 3 to 6 weeks for underwriters to process. The processing time of your application depends on several factors.

1. Did you apply online or with a paper application?

Paper applications are taking a week or two longer to process. They must first be entered into the electronic system before they are seen by underwriters. This added step can hold up the processing of your application for weeks.

2. Did you include prior doctor information?

Applicants who do not include prior doctor information may end up waiting longer for their applications to be processed. When this information is not included, Kaiser underwriters must do detective work to find the information. Connecting with former doctors and getting medical records is hard enough, but when they do not have the doctor’s contact information, it really slows them down.

3. Do you have many pre-existing health conditions?

Applications with more pre-existing health conditions are simply more complicated to process. At times, underwriters have to seek additional information from clients or former doctors in order to know how serious these conditions are and whether or not they are cause for denial.

If you are waiting to find out the status of your Kaiser Permanente health insurance application, do not cancel your existing coverage until you know that you are approved. If you find out days or weeks after your effective date, you may want to move your effective date up a month, so you do not end up paying for coverage you did not actually receive.

Posted: December 31st, 2008 under California Individual.
Comments: none

You may use your credit/debit card or receive a monthly invoice to pay your health insurance premium. At the end of the online application, there is a section (a popup window) where you can enter your credit card information. If you enter your credit card here, once your application is approved, your card will be charged. 

What if I don’t want to use my credit card?
Currently, you can just leave the credit card fields blank. Close the popup window and continue your application. Then, once your application is approved, you will be billed by monthly invoice. Your bill will come each month around the 11^th of the month. 

What if my credit card gets charged and I need it to be refunded?
Once, your application is approved, your credit card will be charged. However, you have 30 days from your effective date to change plans or cancel coverage. Credit card transactions that need to be refunded within 30 days of the original transaction date will be processed as a credit transaction back to the member’s credit card account.  After 30 days, the refund will be processed via the normal paper check refund process through KP Accounts Payable.

Posted: December 29th, 2008 under California Individual.
Comments: none

Often when discussing Kaiser Georgia Personal Advantage Plans, the conversation comes down to talking about the similarities and differences between two of our most popular Individual and Family Plans for Georgia, Plan 2000 and Balance 2000. Though these two plans have a lot of similarities, there are some key differences. The Balance HMO 2000 is a bit more affordable because the coverage is not as rich as Plan 2000.

When comparing the benefits of these plans, you will notice right away that the lifetime maximum for these plans is distinct. Plan 2000 has an unlimited lifetime maximum while Balance 2000 is limited to a lifetime maximum of $3 million. This, along with the fact that Balance 2000 does not cover maternity while Plan 2000 includes pregnancy coverage, are the two biggest differences between these plans.

There are other less dramatic differences related to doctor visits and prescription drug coverage. Plan 2000 covers doctor visits with a $30 copayment while Balance HMO 2000 has a $40 copayment. Copayments for prescription drugs (generic/brand) are a bit more expensive for the Balance 2000 as well, $20/$40 at Kaiser Permanente for the Balance 2000 Plan and $15/$30 for Plan 2000. Similarly, the copayments for prescription drugs outside of Kaiser at places like Walgreens are a little cheaper for those on Plan 2000.

Posted: December 17th, 2008 under Georgia Individual.
Comments: none

Currently insured Kaiser members often want to add family members to their account. Perhaps you got married, had a baby, or adopted a child. Perhaps some family members were covered on a group plan or were with another carrier. Whatever the reason, you have one or more covered Kaiser Permanente family members and you want to move another family member or more family members onto your plan. You can accomplish this through either completing a paper application or an online application, it tends to be a bit easier if you use the paper method, which you can submit by fax or mail. 

Add a Member Using the Paper Application: On page 1, Section II, answer “Yes” to question 1 that states: “Are you adding a family member to an existing Individuals and Families Plan account?” Then complete and submit the application.   

Adding a Member Using the Online Application: When using the online application to add a family member, list the name of the existing subscriber in the billing section. Or, have the new applicant complete the application, and then call Member Services to merge the accounts after the application is approved.

Posted: December 16th, 2008 under California Individual.
Comments: none

Kaiser Permanente offers nine dental health insurance plans through Delta Dental. Small businesses who enroll in a Kaiser group health insurance plan may add dental coverage. The two DeltaCare plans, the DeltaCare 10A and the DeltaCare 13B, tend to be the most popular. These plans offer the lowest monthly premiums, two free teeth cleanings a year, orthodontic coverage and more. Members enrolled on these plans have a smaller pool of dentists to choose from, but many employers and employees feel the lower monthly premiums more than makes up for the limited selection.

There are six rate areas for the Delta Dental Plans. Northern California rate areas include North Valley and the Bay Area. Southern California rate areas include Coachella Valley, Kern County, San Diego and Southern California. The Southern California rate area includes Los Angeles County, Orange County, Riverside County (excluding Coachella Valley), San Bernardino County and Ventura County.

The group DeltaCare plans are broken up into two rate areas: Northern California and Southern California.

Posted: December 15th, 2008 under California Group.
Comments: none

Kaiser Permanente Individual and Family members choose to change plans for various reasons. Perhaps you want to lower your monthly premium. You may wish to increase coverage or get a plan with certain benefits not provided with your current medical insurance coverage. Or, you may want a plan that is HSA-qualified, so you can open a Health Savings Account and benefit from the tax advantages. Whatever your reason for changing plans, you will find instructions for making a switch in health insurance coverage below. The procedures you will follow will depend on two factors:

1. Are you upgrading or downgrading plans?
2. How long has it been since your coverage began?

If it’s been 30 days or less since your effective date, follow the directions in Section A. If it’s been 31 days or more since your effective date, follow the directions in Section B. 

Section A: 30 Days or Less from Your Effective Date

A new insured can still switch plans (up or down) within the first 30 days of their effective date without reapplying.  To switch, fax a letter to Kaiser Permanente. Include your name, date of birth, signature and information regarding the plan to which you want to change. Use the appropriate fax number below:

• If you are in Southern California, fax to: 1-858-614-3345
• If you are in Northern California, fax to: 1-858-614-3344

Section B: 31 Days or More from Your Effective Date

Download the Plan Change Form for instructions on how to determine whether the change you wish to make is a downgrade or an upgrade. Then, follow the instructions below:

• If You Are Downgrading Plans: To downgrade after the first 30 days, the insured must complete the Plan Change form. Use the link above to download this form.
• If You Are Upgrading Plans: To upgrade after the first 30 days, the insured must reapply. Do not cancel your current coverage. If your new application is approved, you will be switched to the new plan. If it is denied, you may keep your current plan.

Posted: December 10th, 2008 under California Individual.
Comments: none

Durable Medical Equipment: All small group health insurance plans from Kaiser California cover base equipment like canes, crutches, and wheelchairs. However, only the $5, $15, and $20 Copayment Plans cover formulary equipment like C-Pap machines and other breathing apparatus.   

Prosthetic and Orthotic Devices: By law, all California small business medical plans cover prosthetic and orthotic devices. 

Note: For more information click here: http://kaiserquotes.com/california-health-insurance/group.php

Posted: December 9th, 2008 under California Group.
Comments: none

Online Applicants

If you apply online, you will receive your status online. After about three weeks, you will receive an email directing you to log back into your account. Once you log in, you will be able to view your status. 

Paper Applications by Fax or Mail

Those who apply using a paper application, will be notified by mail. Currently, it usually takes three to four weeks to find out the status of an applicant who submits enrollment forms by fax or mail.

Posted: December 8th, 2008 under California Individual.
Comments: none