Dual Choice PPO helps make it more convenient to find doctors and facilities for your care.
Here’s an overview of getting care with Dual Choice PPO. You have the option to see Kaiser Permanente Providers in Oregon and Washington, First Choice Health and First Health Network providers, or any licensed provider.
Some in-network providers, including Kaiser Permanente, have lower cost shares for primary care, urgent care, specialty care, routine eye exam visits, and mental health and chemical dependency outpatient services. This is referred to as an enhanced benefit.
In-network providers who offer Enhanced Benefits are identified with an asterisk (*) in the provider directory. Visit the Dual Choice PPO Provider Directory for a searchable provider directory.
Yes. If you were seeing a doctor who is not a member of the First Choice Health or First Health Network, you can nominate that doctor to join our network. Please keep in mind your provider may choose not to be contracted.
To nominate a provider, call 1-866-616-0047 First Choice Health Provider Nomination Form.
(TTY 711) or you can complete and submit theReview can take up to six months. Whether a physician or practitioner is accepted depends on a number of considerations, including the provider’s interest in joining, so a nomination doesn’t guarantee acceptance.
Kaiser Foundation Health Plan of the Northwest offers several networks that include the Kaiser Permanente integrated health care delivery system. The networks include physicians, specialists, and facilities that provide services to individuals and groups covered under Kaiser Permanente plans. The primary contracted provider groups and facilities that participate include:
The Dual Choice network is composed of the Kaiser Permanente integrated health care delivery system (as described above) and most First Choice Health providers and facilities in Oregon and Washington.
For members enrolled with a Washington employer, the Dual Choice network includes access to the First Health Network in states other than Oregon, Washington, Idaho, Montana, Wyoming, North Dakota, South Dakota, and Alaska as in-network providers.
The Dual Choice network is designed to offer access to a broad provider network that includes both Kaiser Permanente providers and a nationwide network at the in-network benefit level. Members can also access out-of-network providers and facilities, although out-of-pocket expenses are generally higher than the in-network provider options.
You can work directly with any licensed provider or facility anywhere.
No referral is needed for office visits to Out-of-Network Providers or specialists. Some services are accessed through referral and prior authorization. You or your authorized representative must obtain prior authorization by calling 1-855-281-1840 (TTY 711).
The provider you choose affects your copays, coinsurance and deductibles. You’ll generally have the lowest costs when you get care from a select group of in-network providers, higher costs when you get care from First Choice Health and First Health Network providers, and the highest costs when you get care from out-of-network providers.