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Kaiser - KP GA Signature Silver 2750/20% HSA
Georgia, 2018
Plan Type
HMO
Metal Tier
Silver
Out of Pocket Maximum
$6,000
Deductible
$2,750
Call (855) 782-0916 to speak with a licensed agent about a new health plan.
Emergency Room Care: 20% 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) | $2,750 |
|---|---|
| Deductible (Family) | $5,500 |
| Coinsurance | Not applicable |
| Out of Pocket Maximum (Individual) | $6,000 |
| Out of Pocket Maximum (Family) | $12,000 |
Doctor Visits
| Primary Care Visit | 20% Coinsurance after deductible |
|---|---|
| Specialist Visit | 20% Coinsurance after deductible |
| Inpatient Facility | 20% Coinsurance after deductible |
| Inpatient Physician | 20% Coinsurance after deductible |
| Emergency Room Services | 20% Coinsurance after deductible |
Tests and Imaging
| Imaging (CT/PET Scans, MRIs) | 20% Coinsurance after deductible |
|---|---|
| Laboratory Outpatient and Professional Services | 20% Coinsurance after deductible |
| X-Ray and Diagnostic Imaging | 20% 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 | 20% Coinsurance after deductible |
|---|---|
| Mental / Behavioral Health Outpatient | 20% Coinsurance after deductible |
| Rehabilitative Speech Therapy | 20% Coinsurance after deductible |
| Rehabilitative Occupational & Physical Therapy | 20% Coinsurance after deductible |
| Outpatient Facility | 20% Coinsurance after deductible |
| Outpatient Surgery | 20% Coinsurance after deductible |
Prescription Drugs
| Generic Rx | $15 Copay after deductible |
|---|---|
| Preferred Brand Rx | $45 Copay after deductible |
| Non Preferred Brand Rx | 50% Coinsurance after deductible |
| Specialty Drugs | 50% Coinsurance after deductible |
73% Cost Sharing Benefits
Households with incomes between 200% to 250% of FPL qualify for the following cost sharing benefits for this silver plan. To understand how cost sharing reductions work and how they work for you see our article about Obamacare Cost Sharing Reduction Discounts
Deductibles and Cost Sharing
| Deductible (Individual) | $1,700 |
|---|---|
| Deductible (Family) | $3,400 |
| Out of Pocket Maximum (Individual) | $5,000 |
| Out of Pocket Maximum (Family) | $10,000 |
Doctor Visits
| Primary Care Physician | 20% Coinsurance after deductible |
|---|---|
| Specialists | 20% Coinsurance after deductible |
| Emergency Room | 20% Coinsurance after deductible |
| Inpatient Facility | 20% Coinsurance after deductible |
| Inpatient Physician | 20% Coinsurance after deductible |
Prescription Drugs
| Generic Rx | $15 Copay after deductible |
|---|---|
| Preferred Brand Rx | $45 Copay after deductible |
| Non Preferred Brand Rx | 50% Coinsurance after deductible |
| Specialty Drugs | 50% Coinsurance after deductible |
87% Cost Sharing Benefits
Households with incomes between 150% to 200% of FPL qualify for the following cost sharing benefits for this silver plan.
Deductibles and Cost Sharing
| Deductible (Individual) | $500 |
|---|---|
| Deductible (Family) | $1,000 |
| Out of Pocket Maximum (Individual) | $2,250 |
| Out of Pocket Maximum (Family) | $4,500 |
Doctor Visits
| Primary Care Physician | 10% Coinsurance after deductible |
|---|---|
| Specialists | 10% Coinsurance after deductible |
| Emergency Room | 10% Coinsurance after deductible |
| Inpatient Facility | 10% Coinsurance after deductible |
| Inpatient Physician | 10% Coinsurance after deductible |
Prescription Drugs
| Generic Rx | $10 Copay after deductible |
|---|---|
| Preferred Brand Rx | $20 Copay after deductible |
| Non Preferred Brand Rx | 50% Coinsurance after deductible |
| Specialty Drugs | 50% Coinsurance after deductible |
94% Cost Sharing Benefits
Households with incomes between 138% to 150% of FPL qualify for the following cost sharing benefits for this silver plan.
Deductibles and Cost Sharing
| Deductible (Individual) | $100 |
|---|---|
| Deductible (Family) | $200 |
| Out of Pocket Maximum (Individual) | $1,000 |
| Out of Pocket Maximum (Family) | $2,000 |
Doctor Visits
| Primary Care Physician | 5% Coinsurance after deductible |
|---|---|
| Specialists | 5% Coinsurance after deductible |
| Emergency Room | 5% Coinsurance after deductible |
| Inpatient Facility | 5% Coinsurance after deductible |
| Inpatient Physician | 5% Coinsurance after deductible |
Prescription Drugs
| Generic Rx | $10 Copay after deductible |
|---|---|
| Preferred Brand Rx | $15 Copay after deductible |
| Non Preferred Brand Rx | 50% Coinsurance after deductible |
| Specialty Drugs | 50% Coinsurance after deductible |
Other Plans in Georgia
| Plan | Deductible | Coinsurance | Out of Pocket |
|---|---|---|---|
| Plan KP GA Bronze 5000/50 | Deductible $5,000 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan KP GA Signature Gold 500/20 | Deductible $500 | Coinsurance Not applicable | Out of Pocket $6,350 |
| Plan KP GA Signature Gold 1500/20 | Deductible $1,500 | Coinsurance Not applicable | Out of Pocket $5,000 |
| Plan KP GA Catastrophic 7350/0 | Deductible $7,350 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan KP GA Silver 4700/35 | Deductible $4,700 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan KP GA Signature Silver 4700/35 | Deductible $4,700 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan KP GA Signature Silver 3000/30 | Deductible $3,000 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan KP GA Signature Silver Std 3500/30 | Deductible $3,500 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan KP GA Silver 2750/20% HSA | Deductible $2,750 | Coinsurance Not applicable | Out of Pocket $6,000 |
| Plan KP GA Gold 500/20 | Deductible $500 | Coinsurance Not applicable | Out of Pocket $6,350 |
| Plan KP GA Signature Bronze 5000/50 | Deductible $5,000 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan KP GA Signature Catastrophic 7350/0 | Deductible $7,350 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan KP GA Bronze 6200/40%/HSA | Deductible $6,200 | Coinsurance Not applicable | Out of Pocket $6,550 |
| Plan KP GA Gold 1500/20 | Deductible $1,500 | Coinsurance Not applicable | Out of Pocket $5,000 |
| Plan KP GA Silver Std 3500/30 | Deductible $3,500 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan KP GA Signature Bronze 6200/40%/HSA | Deductible $6,200 | Coinsurance Not applicable | Out of Pocket $6,550 |
| Plan KP GA Silver 3000/30 | Deductible $3,000 | Coinsurance Not applicable | Out of Pocket $7,150 |