Information and Resources for Kaiser Permanente Members
As of March 1, 2024, Kaiser Permanente (KP) members in Boulder County have more care options closer to home thanks to two new agreements with Boulder Community Health (BCH) and the Boulder Valley Care Network (BVCN).
For questions on providers, care, and coverage, Kaiser Permanente encourages you to call the customer service phone number on your ID card. Here are some additional FAQs and links that may be helpful.
Boulder Community Health facilities for Kaiser Permanente Members:
Q: What does the agreement between BCH and KP mean for KP members?
A: In a new comprehensive facilities agreement, BCH’s Foothills Hospital
becomes part of the KP hospital network for nearly all KP members.
Q: What plans are included in BCH-KP facilities contract?
A: As of March 1, 2024, KP members with the following plans have in-network
access to BCH facilities:
- Commercial Choice HMO
- Commercial Choice PPO
- Medicare Senior Advantage PPO
- Medicare Senior Advantage HMO (Denver/Boulder service area only)
- KP Colorado Option for Small Group
Q: What plans are not included in the contract?
A: KP Select and Medicare Advantage Northern Colorado plans are not included
in the agreement and remain out of network.
Q: Are there any facilities not included in the BCH-KP agreement?
A: The following locations will be ADDED to the agreement and become in-network
as of October 1, 2024:
- Boulder MRI (Located at Community Medical Center in Lafayette)
- Boulder Sports Medicine Imaging
- Boulder Surgery Center
- Endoscopy Center of the Rockies
- Foothills Surgery Center
- Premier Eye Surgery
Q: Are Urgent Care and Emergency Department services in network for Kaiser members?*
A: BCH Emergency Departments and the BCH Urgent Care are in-network for:
Kaiser Plan |
BCH Urgent Care |
BCH Emergency Departments |
Commercial PPO |
Yes |
Yes |
Commercial HMO |
No |
Yes |
Medicare Advantage PPO
|
Yes |
Yes |
Medicare Advantage HMO
|
Yes |
Yes |
*BCH Urgent Care and Emergency Departments are NOT in network for Kaiser Select members.
Q: Do I need to create a BCH patient portal account?
A:
MyBCH patient portal account is recommended, but not required to receive
care at BCH.
Download the MyBCH mobile app to schedule and manage appointments, access your test results, pay your bill, check-in online, request prescription refills and much more.
How do I sign up?
You can use the links below to download the MyBCH app.
Patients who wish to participate will be issued a MyBCH activation code when they receive a service at any BCH patient care facility. This code will enable you to log in and create your own username and password. If you were not issued an activation code or lost it, please contact the Health Information Management (HIM) department at MyBCH@bch.orgor 303-415-7760. You may also sign up without an activation code via the “sign up now” link on the app or the MyBCH login page.
Note: If you have an existing Kaiser Permanente patient portal account, you can link it to your new MyBCH patient portal when you create a MyBCH portal account.
Boulder Valley Care Network for Kaiser Permanente
Q: What does the agreement between BVCN and KP mean for members?
A: The Boulder Valley Care Network (BVCN) is a clinically integrated network
of Boulder Community Health providers and members of the Boulder Valley
Independent Practice Association. KP signed a provider agreement with
the BVCN that will offer more provider options for most KP members.
Members of some Kaiser plans now have in-network access to the 600 primary care and specialist physicians in the BVCN. These physicians work cooperatively to help you stay healthy by providing affordable quality care that’s evidence-based, accessible, equitable, and focused on optimal outcomes. Please call Kaiser directly to ensure your plan is In Network for professional services.
To see a directory of BVCN doctors and advanced practice providers, search participating providers here.
This agreement also includes access to facilities across the county, such as the Della Cava Family Medical Pavilion in Boulder, Community Medical Center in Lafayette, and Erie Medical Center in Erie.
Q: What plans are included in the BVCN-KP contract?
A: As of March 1, 2024, KP members with the following plans have in-network
access to providers in the BVCN:
- Commercial Choice PPO
- Medicare Senior Advantage PPO
- Medicare Senior Advantage HMO (Denver/Boulder service area only)
Q: What plans are not included in the contract?
A: KP Select, Kaiser Commercial HMO and Medicare Advantage Northern Colorado
are not included in the agreement and remain out of network
Q: Where can I find information on BVCN providers that are in network for
KP members?
A: We always recommend that you confirm coverage for professional services
for your specific Kaiser plan by calling the Member Services number listed
on your insurance card.
General
Q: I would like to schedule an appointment with a Boulder Valley Care Network
provider. How can I do this?
A:
Coverage varies by plan. Please call to confirm coverage by calling the
Member Services number on the back of your insurance card.
Kaiser Plan |
Primary Care |
Specialty Care |
Commercial PPO |
Some BVCN providers allow scheduling online through the patient portal or members can call the physician office directly. |
Authorization may be required. Authorizations are based on the service being requested. If authorization is required, your referring PCP or specialist can request one. While Kaiser insurance may not require referral orders, our specialty clinics require a referral order from the PCP for new patients. Once the order has been submitted please call the office directly for scheduling. |
Commercial HMO |
BVCN providers are out of network |
BVCN providers are out of network |
Medicare Advantage PPO |
Some BVCN providers allow scheduling online through the patient portal or members can call the physician office directly. |
Authorization may be required. Authorizations are based on the service being requested. If authorization is required, your referring PCP or specialist can request one. While Kaiser insurance may not require referral orders, our specialty clinics require a referral order from the PCP for new patients. Once the order has been submitted please call the office directly for scheduling. |
Medicare Advantage HMO |
Some BVCN providers allow scheduling online through the patient portal or members can call the physician office directly. |
Authorization may be required. Authorizations are based on the service being requested. If authorization is required, your referring PCP or specialist can request one. While Kaiser insurance may not require referral orders, our specialty clinics require a referral order from the PCP for new patients. Once the order has been submitted please call the office directly for scheduling. |
Medicare members:
To find a provider or facility near you:
- Senior Advantage (HMO) Medicare health plan: visit kp.org/locations
- Senior Advantage Choice (PPO) Medicare health plan: visit kp.org/MedicarePPO-CO
- For questions or assistance in finding a provider, call 1-800-476-2167 (TTY 711). Hours are 8 a.m. to 8 p.m., 7 days a week.
- To make an appointment, call the provider directly.
For non-Medicare Choice PPO health plan members:
To find a provider or facility near you:
- Choice PPO health plan: visit kp.org/choiceppo-colorado
- For questions or assistance in finding a provider, call 1-855-364-3184 (TTY 711), Monday through Friday, 8 a.m. to 6 p.m.
- To make an appointment, call the provider directly.
Helpful Links
Kaiser Plan information:
PPO Commercial = Choice PPO plans only
- https://healthy.kaiserpermanente.org/content/dam/kporg/final/documents/community-providers/co/kpco-ppo-provider-manual-section-3-member-eligibility-benefits.pdf
- Page 10 section 3.5.8
PPO Medicare = Senior Advantage Choice PPO
- Sample card can be found by visiting https://healthy.kaiserpermanente.org/content/dam/kporg/final/documents/community-providers/co/kpco-ppo-provider-manual-section-3-member-eligibility-benefits.pdf
- Page 6 section 3.5.2 & 3.5.3
Medicare = Traditional HMO Medicare
- Sample card can be found by visiting https://healthy.kaiserpermanente.org/content/dam/kporg/final/documents/community-providers/co/kpco-provider-manual-section-3-member-eligibility-benefits-en.pdf
- Page 13 section 3.5.7
- HMO Medicare Advantage members must stay within their region i.e. Boulder/ Denver.