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) |
$6,550 |
Deductible (Family) |
$13,100 |
Coinsurance |
Not applicable |
Out of Pocket Maximum (Individual) |
$6,550 |
Out of Pocket Maximum (Family) |
$13,100 |
Doctor Visits
Primary Care Visit |
0% Coinsurance after deductible |
Specialist Visit |
0% Coinsurance after deductible |
Inpatient Facility |
0% Coinsurance after deductible |
Inpatient Physician |
0% Coinsurance after deductible |
Emergency Room Services |
0% Coinsurance after deductible |
Tests and Imaging
Imaging (CT/PET Scans, MRIs) |
0% Coinsurance after deductible |
Laboratory Outpatient and Professional Services |
0% Coinsurance after deductible |
X-Ray and Diagnostic Imaging |
0% 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 |
0% Coinsurance after deductible |
Mental / Behavioral Health Outpatient |
0% Coinsurance after deductible |
Rehabilitative Speech Therapy |
0% Coinsurance after deductible |
Rehabilitative Occupational & Physical Therapy |
0% Coinsurance after deductible |
Outpatient Facility |
0% Coinsurance after deductible |
Outpatient Surgery |
0% Coinsurance after deductible |
Prescription Drugs
Generic Rx |
0% Coinsurance after deductible |
Preferred Brand Rx |
0% Coinsurance after deductible |
Non Preferred Brand Rx |
0% Coinsurance after deductible |
Specialty Drugs
| 0% Coinsurance after deductible |
Other Plans in Oregon
Plan
Kaiser Permanete Oregon Standard Gold Plan
|
Deductible
$1,000 |
Coinsurance Not applicable |
Out of Pocket
$6,850 |
Plan
KP OR Bronze 6500/50
|
Deductible
$6,500 |
Coinsurance Not applicable |
Out of Pocket
$7,350 |
Plan
KP OR Silver 3500/30
|
Deductible
$3,500 |
Coinsurance Not applicable |
Out of Pocket
$7,350 |
Plan
KP OR Bronze 5000/50
|
Deductible
$5,000 |
Coinsurance Not applicable |
Out of Pocket
$7,350 |
Plan
Kaiser Permanente Oregon Standard Silver Plan
|
Deductible
$2,500 |
Coinsurance Not applicable |
Out of Pocket
$7,350 |
Plan
KP OR Gold 1000/20
|
Deductible
$1,000 |
Coinsurance Not applicable |
Out of Pocket
$7,000 |
Plan
KP OR Gold 0/20
|
Deductible
$0 |
Coinsurance Not applicable |
Out of Pocket
$7,000 |
Plan
KP OR Catastrophic 7350/0
|
Deductible
$7,350 |
Coinsurance Not applicable |
Out of Pocket
$7,350 |
Plan
KP OR Silver 2500/30
|
Deductible
$2,500 |
Coinsurance Not applicable |
Out of Pocket
$7,350 |