Women's Health Care Services

Infertility treatment is an exclusion on most plans. Large groups may purchase a benefit to provide coverage for treatment of infertility and sterility. Self-funded plans may elect to track the benefit differently, if they choose to purchase a benefit. Check the Evidence of Coverage to confirm the benefit.

Women's health care services including maternity care, covered reproductive health services, preventive services (well care) and general examinations, gynecology care, and follow-up visits for the above services (check the member's Evidence of Coverage to understand limitations in this area) may be obtained from Kaiser Permanente or Kaiser Permanente-contracted providers without prior authorization. Providers include general and family practitioner, physician's assistant, gynecologist, certified nurse midwife, licensed midwife, doctor of osteopathy, pediatrician, obstetrician or advance registered murse practitioner.

The member's primary care provider or personal physician must manage other health conditions, coordinate care, and arrange for referrals to subspecialists.

If the provider diagnoses a condition that requires hospitalization or a referral to another specialist, the member or the provider must obtain pre-authorization and care coordination in accordance with applicable Kaiser Permanente requirements.

For other women's health care resources, see Abortion Services.

Reviewed 05/04/2018

The Provider Manual is not intended for any use by any party other than as a resource for Kaiser Foundation Health Plan of Washington's contracted providers in fulfilling their obligations under provider contracts. Kaiser Permanente intends for the manual to be accurate for its intended purpose but doesn’t guarantee accuracy. Providers should comply with the terms of their provider contracts and any legal requirements in the event of an inconsistency between the manual and a requirement in their provider contracts or the law.