2024 Evidence of Coverage for WA PEBB Kaiser Permanente Senior Advantage 25 Chapter 1: Getting started as a member Section 2.4 – U.S. citizen or lawful presence A member of a Medicare health plan must be a U.S. citizen or lawfully present in the United States. Medicare (the Centers for Medicare & Medicaid Services) will notify us if you are not eligible to remain a member on this basis. We must disenroll you if you do not meet this requirement. Section 3 — Important membership materials you will receive Section 3.1 – Your plan membership card While you are a member of our plan, you must use your membership card whenever you get services covered by our plan. You should also show the provider your Medicaid card, if applicable. Here's a sample membership card to show you what yours will look like: Do NOT use your red, white, and blue Medicare card for covered medical services while you are a member of this plan. If you use your Medicare card instead of your Senior Advantage membership card, you may have to pay the full cost of medical services yourself. Keep your Medicare card in a safe place. You may be asked to show it if you need hospital services, hospice services, or participate in Medicare-approved clinical research studies also called clinical trials. If your plan membership card is damaged, lost, or stolen, call Member Services right away and we will send you a new card. Section 3.2 – Provider Directory The Provider Directory lists our current network providers and durable medical equipment suppliers. Network providers are the doctors and other health care professionals, medical groups, durable medical equipment suppliers, hospitals, and other health care facilities that have an agreement with us to accept our payment and any plan cost-sharing as payment in full. You must use network providers to get your medical care and services. If you go elsewhere without proper authorization, you will have to pay in full. The only exceptions are emergencies, urgently needed services when the network is not available (that is, in situations when it is 1-877-221-8221 (TTY 711), 7 days a week, 8 a.m. to 8 p.m.