Patient Financial Policy page 1 of 2
Kaiser Permanente
Patient Financial Responsibility
Thank you for choosing Kaiser Permanente for your care. We are committed to providing you with quality,
affordable health care. We have prepared the following information to help you understand how we work
together to make sure you have the information you need to meet your financial responsibilities for the
care and services you receive.
Know which services your insurance will cover
Health insurance coverage is a contract between you and your insurance company. It’s best if you know
which services your insurance will cover before you receive care. That way, there are no surprises for
either of us. If you’re not sure about your coverage, please ask your insurance company. Kaiser
Permanente health plan members can call Member Services at 1-888-901-4636. For other insurance
companies, please refer to the information on the back of your insurance card. If you have no insurance,
or do not give us correct information, you will be responsible for the full cost of the services you receive.
Insurance billing
•Contracted coverage Kaiser Permanente in the Puget Sound and Spokane contracts with several
insurance companies in addition to our own plans. If we are in your health plan’s network, our billing
office will submit claims to your insurance company for the care and services you receive from us. You
will be expected to pay any cost shares at the time of service.
•Non-contracted If Kaiser Permanente does not contract with your insurance plan, we will bill your
insurance as a courtesy to you, and may ask you for payment at the time you receive care. You are
responsible for the full cost of the care and services you receive. If you owe a balance, or if your
insurance company does not pay your claim within 45 days, the balance will be billed to you.
Copayments, deductibles and other patient cost shares
Please plan to pay your copayment at the time you receive care or services. This amount is based on
your specific insurance plan. We will also ask you to pay any deductibles, money owed for non-covered
services, and any other cost shares at the time of service. If you are not able to pay these amounts at the
time you receive care or services, you will receive a bill. The total amount you owe might change after
your appointment, depending on the actual care or services you receive. You are responsible for all or
part of the charges, based on your coverage and insurance plan. It is important to know that even if a
service is covered, your insurance plan might not pay the charges in full.
Care or services not covered by your insurance plan
Not every service is covered by every insurance plan. Some or all of the care or services you receive
might not be covered, or might not be considered medically necessary by your insurance plan. If that is
the case, you will be responsible for the full cost. We will usually ask your insurance company to approve
services in advance if there is any question about coverage. If you receive a service that is not covered,
we will expect payment in full at the time of your visit.
Adult bringing a minor for care or services is financially responsible
An adult who brings a minor (under 18 years of age) to Kaiser Permanente for care or services, or the
parent or guardian, is responsible for any payments that are due at the time care or services are received.
If a responsible adult is not present or payment has not been arranged in advance, treatment that is not
urgent may be rescheduled.
Pharmacy charges
Pharmacy cost shares are due and should be paid when your prescription is filled. The amount of your
cost share is based on pharmacy coverage in your insurance plan. When you order prescriptions online
you can pay using a debit or credit card.
Missed appointments
If you miss an appointment, or do not cancel your appointment within a reasonable amount of time, we
might charge you a cancellation fee, depending upon the type of service. Your insurance will not pay
these fees. They are your responsibility and will be billed directly to you.
