2024 Evidence of Coverage for WA PEBB Kaiser Permanente Senior Advantage 5 Table of Contents Section 2 — Where to get more information and personalized assistance .............................70 Section 3 — To deal with your problem, which process should you use? .............................70 Section 4 — A guide to the basics of coverage decisions and appeals ..................................71 Section 5 — Your medical care: How to ask for a coverage decision or make an appeal of a coverage decision .................................................................................................73 Section 6 — How to ask us to cover a longer inpatient hospital stay if you think you are being discharged too soon .................................................................................................80 Section 7 — How to ask us to keep covering certain medical services if you think your coverage is ending too soon ...........................................................................................86 Section 8 — Taking your appeal to Level 3 and beyond .......................................................91 Section 9 — How to make a complaint about quality of care, waiting times, customer service, or other concerns .......................................................................................................92 Chapter 8 — Ending your membership in our plan .................................................. 96 Section 1 — Introduction to ending your membership in our plan ........................................96 Section 2 — When can you end your membership in our plan? ............................................96 Section 3 — How do you end your Senior Advantage membership? ....................................97 Section 4 — Until your membership ends, you must keep getting your medical items, and services through our plan .................................................................................................97 Section 5 — We must end your membership in our plan in certain situations ......................98 Chapter 9 — Legal notices ....................................................................................... 100 Section 1 — Notice about governing law .............................................................................100 Section 2 — Notice about nondiscrimination .......................................................................100 Section 3 — Notice about Medicare Secondary Payer subrogation rights ...........................100 Section 4 — Administration of this Evidence of Coverage .................................................101 Section 5 — Amendment of Agreement ..............................................................................101 Section 6 — Applications and statements ............................................................................101 1-877-221-8221 (TTY 711), 7 days a week, 8 a.m. to 8 p.m.