Chronic Conditions Management

Chronic conditions are long-lasting health conditions that affect your quality of life and often require special treatment. According to the Center for Disease Control (CDC), 6 in 10 Americans live with at least one chronic condition such as diabetes, arthritis, or depression.

The good news is chronic conditions can be prevented or effectively controlled through a healthy lifestyle, preventive care and ongoing management. With healthcare coverage through SEIU 775 Benefits Group, you have access to affordable, high-quality medical care, including:

  • Free doctor visits: Preventive care visits are free. Your doctor (also called a Primary Care Providers, or PCP) can also refer you to specialists and condition-specific programs.
  • Wellness coaching: A free wellness coach can provide one-on-one guidance to develop healthy habits like eating well, reducing stress and being physically active.
  • Chronic conditions management programs: Specialized programs are available by referral from your doctor. In these programs, a personalized care team will help you manage your condition.

KPWA HMO = Kaiser Permanente Washington HMO, KPNW HMO = Kaiser Permanente Northwest HMO

Chronic Conditions Management

Diabetes is a common chronic health condition that requires special treatment, and prediabetes is even more common. Whether you are prediabetic or have been diagnosed with diabetes, your health plan has many resources for you. These include personalized diabetes management programs, wellness coaching for a healthy lifestyle, and medication and supplies for little-to-no cost.  

Diabetes Management Programs

For KPWA and KPNW members, your doctor can refer you to specialized diabetes management programs.

  • New Insulin Start Program: A 12-week program for those starting insulin for the first time, led by a diabetes nurse.
  • Personalized Care Plan: A 12-24 weeks program led by a dedicated diabetes nurse who will teach you skills for self-managing your diabetes.
  • Ongoing Diabetes Case Management* A program for general diabetes guidance and support from a case manager.

If you are interested in any of these programs, get started by speaking to your doctor.

*KPWA members only: If you have the Kaiser Permanente smartphone app, you can get diabetes case management support on your phone. This is an opt-in service (English only).

No doctor referral is required for Aetna’s diabetes management program.

If you have diabetes or are prediabetic, call Aetna Member Services at 1.855-736- 9469 number and ask for a case manager. They can:

  • Provide support and coaching.
  • Identify gaps in care.
  • Share information about benefits.
  • Review medication details.
  • Refer you to specialists.
  • Provide care in your preferred language or bring an interpreter.

Download the Aetna Health App to access the diabetes management program in English and Spanish.

Wellness Coaching

For KPWA and KPNW members, wellness coaching is available at no-cost and is helpful for people with diabetes, prediabetes and anyone looking to improve their health. No referral from your doctor is required, and you can get coaching from the comfort of your home. A wellness coach can help you:

  • Set goals and stick to them.
  • Eat healthier.
  • Reduce stress.
  • Quit smoking.
  • Increase physical activity.
  • Manage your weight.

Call 1-866-862-4295, Monday to Friday from 7 a.m. to 7 p.m. to make an appointment with a wellness coach or learn more at Kaiser Permanente – Wellness Coaching. Interpretation services are available for this benefit.

Aetna members have free access to AbleTo.

AbleTo gives personalized virtual support to manage chronic pain and improve your physical and emotional health. Through a
mix of therapy and coaching, you can set goals and learn how to meet them over 8 weeks.

Call 1-866-287-1802, Monday to Friday from 9 a.m. to 8 p.m EST. or visit AbleTo.com/Aetna to get started.

AbleTo is available in English and Spanish, with translation services in other languages.

Medication

Insulin: $0 for preferred generic and preferred brand insulin. See your Summary of Benefits (under ‘Prescription Drugs’) for details. 

Diabetes Supplies

Supplies such as needles, syringes and lancets and equipment such as insulin pumps and blood glucose monitors are available for discounted rates. See your Summary of Benefits (under ‘Durable Medical Equipment’) for details. 

Chronic pain directly affects the muscles, joints, bones, ligaments, tendons or nerves. You may feel pain in one targeted area, or throughout your body (such as arthritis). Pain can range from mild to severe enough to interfere with your day-to-day life. Most chronic pain can be treated and prevented in the future with proper care and support! If you’re feeling chronic pain, your health plan has many resources for you. 

Multidisciplinary Care & Physical Coaching Program

MedBridge (available to KPWA and KPNW members):

MedBridge is a physical therapy app available at no-cost to you. After a visit with your physical therapist, you will get a link to get easy access to an exercise and stretching program personalized to your needs, goals and ability.

Available on your computer, tablet, or smartphone, with MedBridge you can: 

  • View your program schedule.  
  • Watch and follow along with videos that show you how to do each exercise. 
  • Track your progress.

How to Find a Physical Therapist 

Go to your Kaiser Permanente Member Portal and log in. From there, you can find an in-network physical therapist with a referral from your primary care doctor.   

  • The easiest way is to start physical therapy is to through an E-visit. Complete a questionnaire about your chronic pain and get directed to the right care.  
  • You can also schedule an in-person physical therapy appointment by using the ‘Find a doctor’ tool. 
Hinge Health: 

Hinge Health is a physical therapy app available at no-cost to you. The program provides all the tools you need to get pain relief from the comfort of home.

Sign up today to: 

  • Get an exercise and stretching program personalized to your needs, goals and ability (including necessary equipment). 
  • Access a care team that includes a health coach and physical therapist for individual support via text, email, phone or video chat. 

With Aetna, no referral is needed for Hinge Health. Begin by making an account and downloading the Hinge Health app. After filling out a questionnaire about your chronic pain, you will be assigned to a physical therapist who will develop and guide your program. 

Get started! 

At this time, Hinge Health is only available in English and Spanish.  

Physical Therapy

  • $15 co-pay (visit limits apply – see your plan summary for details). 
  • Referral required. 
  • $15 co-pay (visit limits apply – see your plan summary for details). 
  • No referral required. 

Alternative Care

KPWA

Acupuncture, massage therapy, naturopathy and chiropractor visits:

  • $0 co-pay (visit limits apply – see your plan summary for details).
  • Referral required for massage therapy only.
KPNW

Acupuncture, naturopathy and chiropractor visits:

  • $0 co-pay (visit limits apply — see your plan summary for details).

Massage therapy:

  • $25 co-pay for up to 12 self-referred visits per year.
  • Referral required.
Aetna

Acupuncture, naturopathy and chiropractor visits:

  • $0 co-pay (visit limits apply — see your plan summary for details).

Massage therapy:

  • $15 co-pay for up to 20 self-referred visits per year.

Learn About Your Health Plan

How to Get Started

Your health plan (KPWA, KPNW or Aetna) is determined by your zip code. If you are unsure which health plan you have, find out here.

There are 3 important steps to get started using your health plan:

  1. Make an online account on your health plan’s website.
  2. Find a primary care doctor and schedule an appointment.
  3. Download your health plan’s smartphone app.

Learn how to take these steps on your health plan: