Understanding Your Plan and Benefits

PPO Provider Network

This network is served by First Choice Health, First Health Network, Cigna Healthcare^SM PPO Network¹ and Kaiser Permanente providers and facilities. Your copay, coinsurance, and deductible are at the same level, regardless of which PPO provider or PPO facility you choose. This network provides care at the lowest out-of-pocket costs.

To find a PPO Provider or confirm if your current provider is part of the PPO Provider Network, please visit our customized locators.

First Choice Health
(Members receiving care in Oregon and Washington.)

First Health Network
(Members receiving care in California, Colorado, Georgia, Hawaii, Maryland, Virginia, and DC.)

Cigna Healthcare^SM PPO Network¹
(Members receiving care in all other states.)

Kaiser Permanente
1-866-616-0047 (TTY 711)

Features and benefits of our plan:

• • Out-of-pocket costs. With PPO Providers, you’ll pay the least out-of-pocket, with a lower or no deductible.
  • Emergency care. You are covered for emergency care anywhere, worldwide.
  • No-cost preventive care. In PPO Provider Network, you pay $0 for preventive care. That includes routine physicals, well-child visits, and certain screenings and tests (such as mammograms).
  • First Choice Health, First Health Network, or Kaiser Permanente. You can choose to receive your medical care through a provider contracted within the First Choice Health or the First Health Network. Or you can use a Kaiser Permanente provider.
  • A wide selection of PPO Providers. The PPO Provider Network consist of doctors, hospitals, specialists, laboratories, and physical therapists across the country.
  • Specialty care. Most First Choice Health or First Health Network providers do not require a referral for specialty care. However, this is determined by the specialty provider so please inquire with them when scheduling your appointment. Your PPO Provider must obtain prior authorization for certain services and treatments² such as:
    • Inpatient hospital stay
    • Outpatient surgery
    • Home health, hospice, and skilled nursing facility services
    • Imaging services
    • Please review your Evidence of Coverage (EOC) for plan details
  • Behavioral health. You can receive care for mental health and drug or alcohol dependency from a provider in the PPO Provider Network.²
  • Hospital care. You can receive inpatient hospitalization services from PPO Provider Network hospitals and facilities. Your PPO Provider may make arrangements for your hospital admission
    • NOTE: Not all providers contracted in the PPO Provider Network have admitting privileges with PPO hospitals. Please confirm the facility and providers are contracted with the PPO Provider Network or you may pay higher out-of-pocket costs.
  • Maternity care. You can choose a PPO Provider for your obstetric care.
  • Lab tests and imaging. You can choose a PPO Provider for lab tests and imaging.
  • Pharmacy services. Learn about your pharmacy benefits on the pharmacy page.

For additional information on what is covered under the PPO Provider Network:

• Refer to your Evidence of Coverage (EOC).
• Contact the human resources/benefits representative where you work, if your employer provides your coverage.
• Call Customer Service at 1-866-616-0047 (TTY 711).

1. The Cigna Healthcare PPO Network refers to the health care providers (doctors, hospitals, specialists) contracted as part of the Cigna Healthcare PPO for Shared Administration.
Cigna Healthcare^SM is an independent company and not affiliated with Kaiser Foundation Health Plan, Inc., and its subsidiary health plans. Access to the Cigna Healthcare PPO Network is available through Cigna Healthcare’s contractual relationship with the Kaiser Permanente health plans. The Cigna Healthcare PPO Network is provided exclusively by or through operating subsidiaries of The Cigna Group, including Cigna Health and Life Insurance Company. The Cigna Healthcare name, logo, and other marks are owned by Cigna Healthcare Intellectual Property, Inc.

2. Inpatient and certain outpatient services are subject to prior authorization. Your First Choice Health and First Health Network Providers must call 1-855-281-1840 (TTY 711) and Cigna Healthcare PPO Network providers must call 1-888-831-0761 for prior authorization. Failure to get prior authorization will result in greater out-of-pocket cost to you.

This site provides an overview of your benefits and services. If there are any differences between this document and your Evidence of Coverage (EOC), your Evidence of Coverage (EOC) will prevail.

For its PPO Provider Network, Kaiser Permanente has contracted with First Choice Health or First Health Network and Cigna Healthcare PPO Network. The list of participating First Choice Health or First Health Network providers is subject to change without notice.