If you need to fill a prescription or seek medical services and your provider is not able to immediately verify your coverage:
Kaiser: Kaiser has a "Believe Me" policy which allows for members to obtain the services they need from their effective date onwards even if coverage cannot be verified or the enrollment has not yet entered the Kaiser system. Any co-payments or charges would be billed according to plan.
Other Plans: Medical Providers: Rather than turn you away, your medical provider will most likely provide the necessary treatment, however you at be required to sign a financial responsibility form that protects the provider and allows them to bill you in the event you did not actually have coverage in place at the time of services. Coverage verification can usually be resolved during the next several business days prior to any billing.
Pharmacies: Many pharmacies will provide you with a one or two day supply for your medication to allow your treatment to proceed until the next business day when health plan member services and the Benefits Service Center can resolve any urgent coverage issues so your prescription may be gilled in its entirety. You may be required to pay the one- or two-day supply however you may contact your plan member services department about filing a claim for reimbursement for any cost above prescription copayment.
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