Keeping Your College Student Covered: Moda and Kaiser Out-of-Area Benefits

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Out of Area Coverage for school-age Dependents

If you have a child heading off to college out of area, you might be wondering how they can keep getting healthcare care while they're away from home.

Important! Please update your child's address directly in the City of Portland Benefits Portal if they move away from home, so they can access the care they need with their new address. Once you log into the Benefits Portal, choose Change My Benefits, then select Life Event, and click Update Dependent Demographic Information Only.

Moda Health Plans Using the Aetna Network

If you're on a City Moda Medical plan, your out of area child has access to a nationwide provider list through the Aetna PPO Network. That means they can find local in-network doctors right in their college town.

Through the Aetna PPO Network, students can search by ZIP code or city, and filter for things like primary care, urgent care, or hospitals.

Delta Dental members can find a nationwide in-network Dental Provider using their same Delta Dental plan. You may find a provider online using the Delta Dental PPO Network.

VSP Vision members can find a nationwide in-network provider using your same VSP plan. (link) You may find a provider online at: www.VSP.com and using the Signature Network.

Kaiser Permanente College Student Health Coverage

College Student Health Coverage| Kaiser Permanente

If your college student is living in a Kaiser region, they can be set up as a Kaiser member in that region, with a new Kaiser Permanente ID card. Students will continue receiving in-network coverage.

For college students enrolled in the City's Kaiser Permanente Medical Plan living outside a Kaiser area, students can still get coverage, but it is more limited. there's a special Dependent Out-of-Area Benefit.

• Gives your student access to certain routine, continuing and follow-up care even when they're living outside the Kaiser service area.
• They can get up to 10 office visits a year - things like preventive checkups, primary care, mental health appointments, and even physical therapy.
• They also get 10 basic X-rays or lab tests, and 10 prescription fills each year.

Most of these services are covered at a 20% cost share, and the provider can bill Kaiser directly. Or, if your child pays out of pocket, you can submit a reimbursement form through KP's Cost and Claims page.

Dental & Vision limitations for Kaiser Dental and Vision:

• Only dental emergencies are reimbursable.
• Vision hardware (e.g., glasses) is not covered; members can download prescriptions to purchase independently.
• These expenses may be eligible for payment or reimbursement using your Healthcare FSA funds.

It's very important to contact your Kaiser Out of Area department to get set up.

Learn more details about Kaiser's College Student Out of Area Dependent Coverage

Use the Away from Home Travel Line at 951-268-3900 (TTY 711) for support and questions about out-of-area setup.

Update Your Dependent's Address in your Benefits Portal

To access out of area care, your child's address must be reported to the City and updated in the City's Benefits Portal so everything processes correctly.

• Once you log into the Benefits Portal, choose Change My Benefits, then select Life Event, and click Update Dependent Demographic Information Only.
• Enter today's date, hit Edit next to your child's name, mark that your child has a different address than you, update their address, and save. Finally, click Approve to confirm.

The new address will then be sent to Moda or Kaiser.

See Step-by-step instructions on how to update your child's information.

Remember, only eligible children enrolled as your Dependent under the age of 26 and are eligible for out-of-area coverage.

If you have questions, please contact the City Employee Benefits Office at [email protected]