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Kaiser - KP GA Bronze Std 6650/45
Georgia, 2017
Plan Type
HMO
Metal Tier
Bronze
Out of Pocket Maximum
$7,150
Deductible
$6,650
Emergency Room Care: 50% Coinsurance after deductible
Cost Sharing Benefits (In Network)
Policyholders are generally responsible for 100% of costs until the deductible amount is met. After the deductible has been met the policyholder is responsible for the coinsurance / copay until the out of pocket maximum is reached at which point the insurance company assumes 100% of all costs.
| Deductible (Individual) | $6,650 |
|---|---|
| Deductible (Family) | $13,300 |
| Coinsurance | Not applicable |
| Out of Pocket Maximum (Individual) | $7,150 |
| Out of Pocket Maximum (Family) | $14,300 |
Doctor Visits
| Primary Care Visit | $45 Copay before deductible + 50% Coinsurance after deductible |
|---|---|
| Specialist Visit | 50% Coinsurance after deductible |
| Inpatient Facility | 50% Coinsurance after deductible |
| Inpatient Physician | 50% Coinsurance after deductible |
| Emergency Room Services | 50% Coinsurance after deductible |
Tests and Imaging
| Imaging (CT/PET Scans, MRIs) | 50% Coinsurance after deductible |
|---|---|
| Laboratory Outpatient and Professional Services | 50% Coinsurance after deductible |
| X-Ray and Diagnostic Imaging | 50% Coinsurance after deductible |
Health Management Programs
| Asthma | Available |
|---|---|
| Depression | Available |
| Diabetes | Available |
| Heart Disease | Available |
| High Blood Pressure / High Cholesterol | Available |
| Lower Back Pain | Available |
| Pain Management | Available |
| Pregnancy | Available |
| Weight Loss | Not available |
Other
| Mental / Behavioral Health Inpatient | 50% Coinsurance after deductible |
|---|---|
| Mental / Behavioral Health Outpatient | Data Not Available |
| Rehabilitative Speech Therapy | 50% Coinsurance after deductible |
| Rehabilitative Occupational & Physical Therapy | 50% Coinsurance after deductible |
| Outpatient Facility | 50% Coinsurance after deductible |
| Outpatient Surgery | 50% Coinsurance after deductible |
Prescription Drugs
| Generic Rx | Data Not Available |
|---|---|
| Preferred Brand Rx | 35% Coinsurance after deductible |
| Non Preferred Brand Rx | 40% Coinsurance after deductible |
| Specialty Drugs | 45% Coinsurance after deductible |
Other Plans in Georgia
| Plan | Deductible | Coinsurance | Out of Pocket |
|---|---|---|---|
| Plan KP GA Silver 2750/20% HSA | Deductible $2,750 | Coinsurance Not applicable | Out of Pocket $6,000 |
| Plan KP GA Catastrophic 7150/0 | Deductible $7,150 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan KP GA Bronze 4500/20 | Deductible $4,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan KP GA Silver 3000/30 | Deductible $3,000 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan KP GA Gold Std 1250/20 | Deductible $1,250 | Coinsurance Not applicable | Out of Pocket $4,750 |
| Plan KP GA Silver Std 3500/30 | Deductible $3,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan KP GA Gold 1500/20 | Deductible $1,500 | Coinsurance Not applicable | Out of Pocket $4,750 |
| Plan KP GA Bronze 6200/40%/HSA | Deductible $6,200 | Coinsurance Not applicable | Out of Pocket $6,550 |
| Plan KP GA Bronze 5700/50 | Deductible $5,700 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan KP GA Gold 500/20 | Deductible $500 | Coinsurance Not applicable | Out of Pocket $6,350 |
| Plan KP GA Silver 2000/30 | Deductible $2,000 | Coinsurance Not applicable | Out of Pocket $7,150 |