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All drug product strengths, formulations, and package sizes &/or types of a formulary drug may not be included on the formulary, check with your Kaiser Permanente pharmacist for clarification, if needed. Kaiser Permanente Colorado Commercial Specialty Tier Drug List 1 Revised: January 17, 2017 Kaiser Permanente Colorado Commercial Specialty Tier Drug List Bold = Formulary & Italics = Non-Formulary The Specialty Tier drug list is subject to change at any time. ABACAVIR SULFATE- LAMIVUDINE ABACAVIR SULFATE- LAMIVUDINE-ZIDOVUDINE ABELCET ABILIFY MAINTENA ACITRETIN ACTEMRA ACTHREL ACTIMMUNE ADAGEN ADCETRIS ADCIRCA ADEFOVIR DIPIVOXIL ADEMPAS ADVATE ADYNOVATE AFINITOR DISPERZ AFSTYLA AKYNZEO ALDURAZYME ALECENSA ALFERON N ALIMTA ALOPRIM ALOXI ALPHANATE ALPHANINE SD ALPROLIX AMBISOME AMMONUL AMPHADASE AMPHOTERICIN AMPYRA AMYTAL SODIUM AMYVID ANASCORP ANCOBON ANTIVENIN LATRODECTUS MACTANS ANTIVENIN MICRURUS FULVIUS APOKYN APTIVUS AQUASOL ARALAST ARANESP ARCALYST ARISTADA ARIXTRA ATOVAQUONE ATRIPLA ATRYN AUBAGIO AVONEX PEN AVYCAZ B-12 COMPLIANCE KIT BAL IN OIL BARACLUDE BEBULIN BELEODAQ BENDEKA BENEFIX BENLYSTA BERINERT BETASERON BETHKIS NEB BIVIGAM BLINCYTO BOSULIF BRAVELLE BRIVIACT BUNAVAIL BUPHENYL POW CABOMETYX CALCIUM DISODIUM VERSENATE CAMPATH CANCIDAS CAPASTAT SULFATE CAPRELSA CARIMUNE NF CAYSTON CEPROTIN CERDELGA CERETEC CEREZYME CETROTIDE CHIRHOSTIM CHOLBAM CHORIONIC GONADOTROPIN CIDOFOVIR CIMZIA CINQAIR CINRYZE CLIN SINGLE USE COAGADEX COMETRIQ COMPLERA Kaiser Permanente utilizes a list of medications that are considered to be specialty drugs. Specialty drugs include self-administered injectables, medications that are typically high cost or medications that require special dispensing and/or monitoring. Some prescription drug plans have a different cost share for specialty drugs. The details of your prescription drug plan can be found in your Evidence of Coverage or Certificate of Insurance. Kaiser Permanente utilizes drug formularies. A drug formulary includes the list of prescription drugs that are preferred and have been approved for our Members. Coverage under your prescription drug plan is determined by the drug formulary; however, many drug plans have specific exclusions, copays or coinsurances that are not reflected in the drug formularies. The drug formularies can be found at kp.org. Specialty Tier Drug List

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  • All drug product strengths, formulations, and package sizes &/or types of a formulary drug may not be included on the formulary,

    check with your Kaiser Permanente pharmacist for clarification, if needed.

    Kaiser Permanente Colorado Commercial Specialty Tier Drug List 1 Revised: January 17, 2017

    Kaiser Permanente Colorado Commercial Specialty Tier Drug List Bold = Formulary & Italics = Non-Formulary

    The Specialty Tier drug list is subject to change at any time.

    ABACAVIR SULFATE-LAMIVUDINE

    ABACAVIR SULFATE-LAMIVUDINE-ZIDOVUDINE

    ABELCET

    ABILIFY MAINTENA

    ACITRETIN

    ACTEMRA

    ACTHREL

    ACTIMMUNE

    ADAGEN

    ADCETRIS

    ADCIRCA

    ADEFOVIR DIPIVOXIL

    ADEMPAS

    ADVATE

    ADYNOVATE

    AFINITOR DISPERZ

    AFSTYLA

    AKYNZEO

    ALDURAZYME

    ALECENSA

    ALFERON N

    ALIMTA

    ALOPRIM

    ALOXI

    ALPHANATE

    ALPHANINE SD

    ALPROLIX

    AMBISOME

    AMMONUL

    AMPHADASE

    AMPHOTERICIN

    AMPYRA

    AMYTAL SODIUM

    AMYVID

    ANASCORP

    ANCOBON

    ANTIVENIN LATRODECTUS MACTANS

    ANTIVENIN MICRURUS FULVIUS

    APOKYN

    APTIVUS

    AQUASOL

    ARALAST

    ARANESP

    ARCALYST

    ARISTADA

    ARIXTRA

    ATOVAQUONE

    ATRIPLA

    ATRYN

    AUBAGIO

    AVONEX PEN

    AVYCAZ

    B-12 COMPLIANCE KIT

    BAL IN OIL

    BARACLUDE

    BEBULIN

    BELEODAQ

    BENDEKA

    BENEFIX

    BENLYSTA

    BERINERT

    BETASERON

    BETHKIS NEB

    BIVIGAM

    BLINCYTO

    BOSULIF

    BRAVELLE

    BRIVIACT

    BUNAVAIL

    BUPHENYL POW

    CABOMETYX

    CALCIUM DISODIUM VERSENATE

    CAMPATH

    CANCIDAS

    CAPASTAT SULFATE

    CAPRELSA

    CARIMUNE NF

    CAYSTON

    CEPROTIN

    CERDELGA

    CERETEC

    CEREZYME

    CETROTIDE

    CHIRHOSTIM

    CHOLBAM

    CHORIONIC GONADOTROPIN

    CIDOFOVIR

    CIMZIA

    CINQAIR

    CINRYZE

    CLIN SINGLE USE

    COAGADEX

    COMETRIQ

    COMPLERA

    Specialty Drugs R

    Kaiser Permanente utilizes a list of medications that are considered to be specialty drugs. Specialty drugs include self-administered injectables, medications that are typically high cost or medications that require special dispensing and/or monitoring. Some prescription drug plans have a different cost share for specialty drugs. The details of your prescription drug plan can be found in your Evidence of Coverage or Certificate of Insurance.

    Kaiser Permanente utilizes drug formularies. A drug formulary includes the list of prescription drugs that are preferred and have been approved for our Members. Coverage under your prescription drug plan is determined by the drug formulary; however, many drug plans have specific exclusions, copays or coinsurances that are not reflected in the drug formularies. The drug formularies can be found at kp.org.

    Specialty Tier Drug List

    http://www.kp.org/

  • Kaiser Permanente Colorado Commercial Specialty Tier Drug List

    All drug product strengths, formulations, and package sizes &/or types of a formulary drug may not be included on the formulary, check with your Kaiser

    Permanente pharmacist for clarification, if needed.

    Kaiser Permanente Colorado Commercial Specialty Tier Drug List 2 Revised: January 17, 2017

    COPAXONE

    CORIFACT

    COSENTYX PEN

    COSMEGEN

    COTELLIC

    CRESEMBA

    CROFAB

    CUBICIN

    CUPRIMINE

    CYANOKIT

    CYRAMZA

    CYSTADANE

    CYTOVENE

    D.H.E.45

    DACOGEN

    DAKLINZA

    DALVANCE

    DATSCAN

    DEPEN TITRATABS

    DESCOVY

    DESFERAL MESYLATE

    DEXAMETHASONE SOD PHOSPHATE/PF

    DIFICID

    DIGIFAB

    DIPENTUM

    DOCEFREZ

    DOCETAXEL

    DORIBAX

    DYSPORT

    EDURANT

    EGRIFTA

    ELAPRASE

    ELELYSO

    ELIGARD

    ELITEK

    ELOCTATE

    EMCYT

    EMPLICITI

    ENBREL

    ENTOCORT EC CPEP

    ENTYVIO

    EPCLUSA

    EPINEPHRINE

    EPOGEN

    EPOPROSTENOL SODIUM

    EPZICOM

    ERAXIS

    ERIVEDGE

    ESBRIET

    ESOMEPRAZOLE SODIUM

    ETHACRYNATE SODIUM

    ETHYOL

    EVOMELA

    EVOTAZ

    EVZIO

    EXJADE

    EXONDYS

    EXTAVIA

    FABRAZYME

    FARYDAK

    FASLODEX

    FEIBA

    FELBATOL

    FERRIPROX

    FIRAZYR

    FIRMAGON

    FLEBOGAMMA

    FLOLAN

    FLUCYTOSINE

    FOLLISTIM AQ

    FOLOTYN

    FONDAPARINUX SODIUM

    FORTEO

    FRAGMIN

    FUZEON

    FYCOMPA

    GAMASTAN S-D

    GAMMAGARD

    GAMMAKED

    GAMMAPLEX

    GAMUNEX-C

    GANCICLOVIR SODIUM

    GANIRELIX

    GATTEX

    GAZYVA

    GEMZAR

    GENOTROPIN

    GENVOYA

    GILENYA

    GILOTRIF

    GLASSIA

    GLATOPA

    GLEEVEC

    GLUMETZA

    GONAL-F RFF

    GONAL-F RFF REDI-JECT

    GRANISETRON

    GRANIX

    H.P. ACTHAR

    HARVONI

    HEMABATE

    HEMOFIL M

    HEPAGAM B

    HEPSERA

    HERCEPTIN

    HETLIOZ

    HEXALEN

    HIZENTRA

    HUMATE-P

    HUMATROPE

    HUMATROPEN

    HUMIRA PEDIATRIC CROHN'S

    HUMIRA PEN CROHN-UC-HS STARTER

    HUMIRA PSKT

    HYCAMTIN

    HYDROXYPROGESTERONE

    HYDROXYPROGESTERONE CAPROATE

    HYLENEX

    HYPERHEP

    HYPERHEP B

    HYPERRAB

    HYPERRAB S-D

    HYQVIA HY

    HYQVIA IG

  • Kaiser Permanente Colorado Commercial Specialty Tier Drug List

    All drug product strengths, formulations, and package sizes &/or types of a formulary drug may not be included on the formulary, check with your Kaiser

    Permanente pharmacist for clarification, if needed.

    Kaiser Permanente Colorado Commercial Specialty Tier Drug List 3 Revised: January 17, 2017

    IBRANCE

    ICLUSIG

    IDELVION

    ILARIS

    IMATINIB MESYLATE

    IMBRUVICA

    IMITREX

    IMPAVIDO

    INCIVEK

    INCRELEX

    INDIUM IN-111 OXYQUINOLINE

    INLYTA

    INTELENCE

    INTRON A

    INVANZ

    INVEGA SUSTENNA

    INVEGA TRINZA

    INVIRASE

    IPRIVASK

    IRESSA

    ISENTRESS CHW

    ISTODAX

    IXEMPRA

    IXINITY

    JADENU

    JAKAFI

    JEVTANA

    JUXTAPID

    KADCYLA

    KALBITOR

    KALETRA

    KALYDECO GRAN PACK

    KANUMA

    KCENTRA

    KENGREAL

    KEPIVANCE

    KEVEYIS

    KEYTRUDA

    KINERET

    KITABIS PAK NEB

    KOATE-DVI

    KORLYM

    KOVALTRY

    KRYSTEXXA

    KUVAN

    KYNAMRO

    KYPROLIS

    LATUDA

    LEMTRADA

    LENVIMA

    LETAIRIS

    LEUKINE

    LEXIVA

    LINEZOLID

    LINEZOLID-0.9% NACL

    LONSURF

    LUMIZYME

    LUPRON DEPOT

    LUPRON DEPOT-PED

    LYNPARZA

    LYSODREN

    MAKENA

    MARQIBO

    MATULANE

    MEKINIST

    MELPHALAN HCL

    MENOMUNE-A-C-Y-W-135

    MENOPUR

    MEPRON

    METASTRON

    MIACALCIN

    MIRCERA

    MIXED VESPID VENOM PROTEIN

    MONOCLATE-P

    MONONINE

    MOZOBIL

    MYALEPT FNL

    MYCAMINE

    MYCOBUTIN

    NABI-HB

    NATPARA

    NATRECOR

    NEULASTA

    NEUPOGEN

    NEXAVAR

    NINLARO

    NIPENT

    NORDITROPIN FLEXPRO

    NORTHERA

    NORVIR SOL

    NOVOEIGHT

    NOVOSEVEN RT

    NOXAFIL

    NPLATE

    NUCALA

    NULOJIX

    NUPLAZID

    NUTROPIN AQ

    NUTROPIN AQ NUSPIN

    NUWIQ

    OBIZUR

    OCALIVA

    OCTAGAM

    OCTREOSCAN

    ODEFSEY

    ODOMZO

    OFEV

    OFIRMEV

    OLYSIO

    ONCASPAR

    OPDIVO

    OPSUMIT

    ORBACTIV

    ORENCIA

    ORENITRAM

    ORFADIN

    ORKAMBI

    OTEZLA

    OTREXUP

    OVIDREL

    PANHEMATIN

    PANRETIN

    PEGASYS PROCLICK

    PEGINTRON REDIPEN

    PHOTOFRIN

  • Kaiser Permanente Colorado Commercial Specialty Tier Drug List

    All drug product strengths, formulations, and package sizes &/or types of a formulary drug may not be included on the formulary, check with your Kaiser

    Permanente pharmacist for clarification, if needed.

    Kaiser Permanente Colorado Commercial Specialty Tier Drug List 4 Revised: January 17, 2017

    PLEGRIDY

    PLEGRIDY PEN

    POMALYST

    PRALUENT

    PREZCOBIX

    PREZISTA

    PRIVIGEN

    PRO-C-DURE

    PROCRIT

    PROCYSBI

    PROFILNINE

    PROLEUKIN

    PROLIA

    PROMACTA

    PROSTASCINT

    PROVAYBLUE

    PROVENGE

    PULMOZYME

    PURIXAN

    RAPAMUNE

    RASUVO

    RAVICTI

    RAYALDEE

    RAYOS

    REBIF REBIDOSE

    RECOMBINATE

    REGRANEX

    RELISTOR

    REMICADE

    REMODULIN

    REPATHA PUSHTRONEX

    REPATHA SURECLICK

    REPATHA SYRINGE

    RETAVASE

    REVATIO

    REVLIMID

    REXULTI

    REYATAZ

    RIFADIN

    RIFAMPIN

    RILUTEK

    RISPERDAL CONSTA

    RITUXAN

    RIXUBIS

    RUBRACA

    RUCONEST

    RYANODEX

    RYNODERM

    SABRIL

    SAIZEN

    SAMSCA

    SANDOSTATIN LAR

    SANDOSTATIN LAR DEPOT

    SAXENDA

    SCULPTRA

    SELZENTRY

    SENSIPAR

    SEROSTIM

    SIGNIFOR

    SIGNIFOR LAR

    SIMPONI ARIA

    SIMULECT

    SIRTURO

    SIVEXTRO

    SODIUM EDECRIN

    SOMATULINE DEPOT

    SOMAVERT

    SORIATANE

    SOVALDI

    SPRITAM

    SPRYCEL

    STELARA

    STIVARGA

    STRENSIQ

    STRIBILD

    SUMAVEL DOSEPRO

    SUTENT

    SYLATRON

    SYLVANT

    SYMLINPEN

    SYNAGIS

    SYNERCID

    SYNRIBO

    SYPRINE

    TACLONEX

    TAFINLAR

    TAGRISSO

    TALTZ AUTOINJECTOR

    TALTZ SYRINGE

    TARCEVA

    TARGRETIN

    TASIGNA

    TAXOTERE

    TECENTRIQ

    TECFIDERA

    TECFIDERA STARTER PACK

    TECHNIVIE

    TEFLARO

    TEMODAR

    TEMOZOLOMIDE

    TENIPOSIDE

    TETRACAINE

    THALOMID

    THIOTEPA

    THROMBATE

    THYROGEN 1.1

    TIVICAY

    TNKASE

    TOBI NEB

    TOBI PODHALER

    TOBRAMYCIN NEBU

    TORISEL

    TRACLEER

    TREANDA

    TRELSTAR

    TRETINOIN

    TRETTEN

    TRISENOX

    TRIUMEQ

    TRIZIVIR

    TRUVADA

    TYGACIL

    TYKERB

    TYSABRI

    TYZEKA

  • Kaiser Permanente Colorado Commercial Specialty Tier Drug List

    All drug product strengths, formulations, and package sizes &/or types of a formulary drug may not be included on the formulary, check with your Kaiser

    Permanente pharmacist for clarification, if needed.

    Kaiser Permanente Colorado Commercial Specialty Tier Drug List 5 Revised: January 17, 2017

    UCERIS

    ULTRAVATE

    UNITUXIN

    UPTRAVI

    VALCHLOR

    VALCYTE

    VALGANCICLOVIR

    VANCOCIN

    VANCOMYCIN

    VAPRISOL-5% DEXTROSE

    VARIZIG

    VECAMYL

    VELCADE

    VELETRI

    VEMLIDY

    VENCLEXTA

    VENCLEXTA STARTING PACK

    VENTAVIS AMPUL-NEB

    VFEND

    VIBATIV

    VIBERZI

    VICTOZA

    VICTRELIS

    VIEKIRA PAK

    VIEKIRA XR

    VIMIZIM

    VIMOVO

    VIRACEPT POW

    VIREAD POW

    VISTOGARD

    VISUDYNE

    VITAMIN K1

    VITEKTA

    VITRASE

    VIVITROL

    VIZAMYL

    VONVENDI

    VORAXAZE

    VOTRIENT

    VPRIV

    VRAYLAR CPPK

    WASP VENOM PROTEIN

    WILATE

    XALKORI

    XELJANZ

    XENAZINE

    XEOMIN

    XGEVA

    XIFAXAN

    XOFIGO

    XOLAIR

    XTANDI

    XURIDEN

    XYNTHA SOLOFUSE

    XYREM

    YERVOY

    YONDELIS

    ZALTRAP

    ZARXIO

    ZAVESCA

    ZELBORAF

    ZEMAIRA

    ZEMBRACE SYMTOUCH

    ZEPATIER

    ZERBAXA

    ZEVALIN

    ZINBRYTA

    ZOFRAN

    ZOLADEX

    ZOLINZA

    ZOMACTON

    ZORBTIVE

    ZORTRESS

    ZUBSOLV

    ZYDELIG

    ZYFLO

    ZYKADIA

    ZYPREXA RELPREVV

    ZYTIGA

    ZYVOX

  • Kaiser Foundation Health Plan of Colorado (Kaiser Health Plan) complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Kaiser Health Plan does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. We also:

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    oo

    Qualified sign language interpreters Written information in other formats, such as large print, audio, and accessible electronic formats

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    60487009 ACA 1557 CO portrait EN 2016 v1

    http://www.hhs.gov/ocr/office/file/index.htmlhttps://ocrportal.hhs.gov/ocr/smartscreen/main.jsf

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    Kaiser Permanente for Individuals and Families

    60436922 National 2016

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    (Armenian): : Kaiser Permanente- , , , , ` :

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    (Bengali):

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    ,

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  • Have questions? Call us at 1-800-494-5314. Go to buykp.org/apply. Or contact your agent or broker.

    Kaiser Permanente for Individuals and Families

    60436922 National 2016

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    (Hindi): Kaiser Permanente

    Hmoob (Hmong): Koj muaj cai kom tau txais kev pab uas hais koj hom lus yam tsis tau them nqi. Yog koj muaj lus nug txog koj daim ntawv thov los yog cov kev pab them nyiaj tim Kaiser Permanente, los yog tias daim ntawv no yog ib tsab ntawv ceebtoom uas yuav kom koj ua ib yam dabtsi raws li hnub tau teev tseg, hu rau tus nab npawb xovtooj uas tau muab rau koj lub xeev lossis cheeb tsam kom tau tham nrog tus kws txhais lus.

    Igbo (Igbo): nwere ikike nweta enyemaka nass g na akwgh gw bla. br na nwere ajj gbasara akwkw anamachihe g ma b mkpuchi si na Kaiser Permanente, ma b br na nke b kwa a chr ka mee ihe tupu otu bch, kp nmba enyere maka steeti ma b mpaghara g iji kwukrta okwu netiti onye kwa okwu.

    Iloko (Ilocano): Adda ti karbenganyo a dumawat iti tulong iti pagsasaoyo nga awan ti bayadanyo. No addaankayo kadagiti saludsod maipanggep ti aplikasionyo wenno coverage babaen ti Kaiser Permanente, wenno no daytoy ket maysa a pakdaar a kalikagumanna a rumbeng nga aramidenyo ti addang iti espesipiko a petsa, tawagan ti numero nga inpaay para ti estado wenno rehion tapno makipatang ti maysa mangipatarus iti pagsasao.

    Option 1

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    60436922 National 2016

    Italiano (Italian): Hai il diritto di ricevere assistenza nella tua lingua gratuitamente. In caso di domande riguardanti la tua richiesta o la copertura attraverso Kaiser Permanente, o se occorre intervenire entro una data specifica secondo quanto indicato in questa comunicazione, chiama il numero fornito per il tuo stato o la tua regione per parlare con un interprete.

    (Japanese): Kaiser Permanente

    (Khmer): Kaiser Permanente

    (Korean): . Kaiser Permanente , .

    (Laotian): . Kaiser Permanente, , .

    Kajin Maj (Marshallese): Ewr jimwe eo a in bk jipa ilo kajin eo a ejjek wn. e ewr a kajjitk kn peba in aplaiki eo a ak insurance eo a jn Kaiser Permanente, ak e enaan in kje in ej aikuj bwe kwn aktkt okta jn juon raan eo ej an kallikkar, kak nba eo ej lek an state eo a ak jik bwe kwn maro knono ippn juon ri-ukt.

    Naabeeh (Navajo): T11 ni nizaad bee n7k1 idoolwo[ doo bik4 as7n7[11g00 47 bee n1haz3. Kaiser Permanente 1k1 an11lwo n1 bik4 azl1adoo y7n7keedgo naaltsoos hadinilaa, 47 b7na7d7[kid doogo, 47 doodago d77 naaltsoos haa7da yoo[k1a[go hait1oda 7d77l77[ ni[n7igo 47 nitsaa hahoodzoj7 47 doodago t11 aadi nahsadi ata dahalne7g77 bich8 h0lnego bee bi[ ahi[ hod77lnih.

    (Nepali): Kaiser Permanente , ,

    Afaan Oromoo (Oromo): Baasii malee afaan keetiin gargaarsa argachuudhaaf mirga qabda. Waaee iyyata keetii yookaan tajaajila Kaiser Permanente hammatu ilaalchisee gaaffii yoo qabaatte, yookaan yoo kun beeksisa guyyaa murtaae irratti tarkaanfii akka ati fudhattu gaafatu tae, lakkoofsa bilbilaa naannoo yookaan goodina keetiif kenname bilbiluudhaan turjumaana haasofsiisi.

    (Persian): .

    Kaiser Permanente

    .

    lokaiahn Pohnpei (Pohnpeian): Komw anehki pwung en rapahki sounkawehwe en omw palien lokaia ni sohte isaihs. Ma mie iren owmi kalelapak ohng aplikeisin de iren audepe kan ohng Kaiser Permanente, de ma pakair wet me anahne komwi en mwekid ohng rahn me kileledi, ah komw anahne koahl nempe me sansalehr ohng owmi palien wehi pwe komwi en lokaiaieng owmi tungoal soun kawehwe.

    Portugus (Portuguese): Voc tem o direito de obter ajuda em seu idioma sem nenhum custo. Se voc tiver dvidas sobre sua solicitao ou cobertura por meio da Kaiser Permanente, ou se este aviso exigir que voc tome alguma medida at uma data especfica, ligue para o nmero fornecido para seu estado ou regio para falar com um intrprete.

  • Have questions? Call us at 1-800-494-5314. Go to buykp.org/apply. Or contact your agent or broker.

    Kaiser Permanente for Individuals and Families

    60436922 National 2016

    (Punjabi): . Kaiser Permanente , , .

    Romn (Romanian): Avei dreptul de a solicita ajutor care s v fie oferit n mod gratuit n limba dumneavoastr. Dac avei ntrebri legate de solicitarea dumneavoastr sau de acoperirea oferit de Kaiser Permanente sau dac acest aviz v solicit s luai msuri pn la o anumit dat, sunai la numrul de telefon furnizat pentru statul sau regiunea dumneavoastr pentru a sta de vorb cu un interpret.

    P (Russian): . Kaiser Permanente, - , , .

    Faa-Samoa (Samoan): E iai lou aia e maua se fesoasoani i lou gagana e aunoa ma le totogi. Afai e iai ni fesili e uiga i lou tusi apalai po o puipuiga e ala mai Kaiser Permanente, po o lenei tusi e manaomia ona e gaoioi i se taimi atofaina, vili le numera ua fuafuaina mo lou setete po o oganuu e fesootai i se faaliliu.

    Espaol (Spanish): Usted tiene derecho a obtener ayuda en su idioma sin costo alguno. Si tiene preguntas acerca de su solicitud o cobertura a travs de Kaiser Permanente, o si este es un aviso que requiere que usted tome alguna medida antes de una fecha determinada, llame al nmero de telfono que se proporciona para su estado o regin para hablar con un intrprete.

    Tagalog (Tagalog): Mayroon kang karapatang humingi ng tulong sa iyong wika nang walang bayad. Kung mayroon kang mga katanungan tungkol sa iyong aplikasyon o coverage sa pamamagitang ng Kaiser Permanente, o kung ito ay abisong nangangailangan ng iyong aksyon sa tiyak na petsa, tumawag sa numerong ibinigay para sa iyong estado o rehiyon para makipag-usap sa isang interpreter.

    (Thai): Kaiser Permanente

    Lea Faka-Tonga (Tongan): Oku ia ho totonu ke ke mau ha fakatonulea taetotongi. Kapau oku i ai hao fehui ki ho tohi kole nae fakafonu ki he malui inisiua a e Kaiser Permanente, pea kapau ko e tohini oku fiemau keke fai ha mea ki ai pe ko ha aho nae tuku pau atu ke fai ia, taa ki he fika kuo oatu ki ho siteiti pe ko e vahefonua oku ke i ai ke talanoa mo ha tokotaha tene fakatonu lea atu kiate koe.

    (Ukrainian): . Kaiser Permanente, , , , .

    (Urdu):

    Kaiser Permanente

    Ting Vit (Vietnamese): Qu v c quyn c nhn tr gip min ph bng ngn ng ca mnh. Nu qu v c cac cu hi v mu n hoc mc bo him ca mnh thng qua Kaiser Permanente, hoc y la thng bao yu cu qu v thc hin vao mt ngay c th, hy gi n s in thoi c cung cp cho bang hoc khu vc ca qu v tr chuyn vi phin dch vin.

    Yorub (Yoruba): O n t lati r ranlw gba npa d r lasan ow. B o ba n br npa w t o k tab edd npa Kaiser Permanente, tab fitnilt y j y o nl lati gbs kan n j kan pat, p nmba t a ps fn pnl tab agbgb r lati ba gbif kan sr.

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