CCC Workbook 2013 - FINAL.pdf - Cherry Creek School District

ALL MEDICAL PLANS
Cherry Creek Choice offers three medical plan options through Kaiser Permanente. You may also choose
to waive coverage under a medical plan but only if you submit evidence that you are covered under another
group medical insurance plan, such as through your spouse’s employer. Each medical option is priced
separately to reflect the benefits of the plan. Each medical plan option is described in detail on the pages
that follow.
CHOICES – THE MEDICAL PLAN OPTIONS ARE:
• Kaiser Permanente Catastrophic DHMO
The Catastrophic DHMO saves you money in premium by including high deductibles and
coinsurance while still offering co-pays for office visits and prescriptions. The Catastrophic
DHMO plan requires you to access care from Kaiser facilities/providers. You may make appointments
directly with your PCP or Specialist. While you may self-refer to a Specialist, Kaiser
Permanente encourages coordinating overall care with your PCP.
• Kaiser Permanente DHMO
The DHMO plan has a lower deductible and co-insurance than the Catastrophic DHMO plan.
The plan requires you to access care from Kaiser facilities/providers. You may make appointments
directly with your PCP, or with a Specialist. While you may self-refer to a Specialist,
Kaiser Permanente encourages coordinating your overall care with your PCP.
• Kaiser Permanente Added Choice Triple Option
The Added Choice Triple Option allows you to choose to access care from Kaiser facilities/
providers or Private Healthcare Systems (PHCS) facilities/providers inside and outside of Colorado
or any other facility/provider. Benefit levels vary based on the facilities/providers accessed.
Co-pays for preventive care apply to tier three. Prescriptions are available outside of
the Kaiser Permanente formulary.
• No Coverage
You may choose to waive all medical coverage only if you submit evidence that you are covered
under another group medical insurance plan by providing a copy of a current ID card that
includes the group name and effective date of benefits.
If you waive all medical coverage at this time, you will not have another opportunity to
enroll for medical coverage until the next enrollment period, unless you qualify for special
enrollment.
PARTICIPATING HOSPITALS AND DOCTORS
The medical plan choices offered vary by the type and level of benefits available, but there are also
important differences having to do with your choice of medical care providers. Kaiser
Permanente has specific lists of participating hospitals, doctors/facilities, and other medical care
providers. For the most current information, you may review these lists on-line at:
• Kaiser Catastrophic DHMO & Kaiser DHMO - www.kp.org
• Kaiser Added Choice Triple Option – www.phcs.com (locally and nationally)
Please note Centura Facilities are not in the PHCS network. Colorado State law requires an
Access Plan describing Kaiser Permanente’s network of providers and services be available.
To obtain a copy, call Customer Service at 303-338-3800.
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