How to identify a Self-funded or HMO member
Each member is issued a Health Identification Card (Health ID Card). Members should present their Health ID Card and photo identification when they seek medical care.
Each member is assigned a unique Health/Medical Record Number, which is used to locate membership and medical information. Every member receives a Health ID Card that shows his or her unique number.
The Health ID Card is for identification only and does not give a member rights to services or other benefits unless he or she is eligible. Anyone who is not eligible at the time of service is responsible for paying for services provided. See the appropriate Provider Manual for more information.
See the Provider Manual for Self-funded members* for pictures of Kaiser Permanente Self-funded member ID Cards. Look at the front of the card for a logo of the self-funded employer that controls the health program. The other key identifier you should look for to identify a self-funded member is found on the back of the card (see samples); look to the right of the phone numbers where it says “KPIC Self-Funded Plan” or similar wording.
If the patient has a Kaiser Permanente Health ID Card that does not have any indicator that it is a self-funded plan, the patient is most likely an HMO member.
You should always confirm that the patient is currently a Kaiser Permanente HMO or self-funded member by calling the appropriate Customer Services (sometimes called “Member Services”) phone number by referring to the key contacts section of the respective Provider Manual or information on the back of the member's ID Card.
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