2019 KP VA Bronze 5500/50/Dental Plan Details - HealthPocket

KP VA Bronze 5500/50/Dental

$404.85/mo

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Zip Code23464
Applicant10/19/1984 Male
Coverage Start10/20/2019
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameKP VA Bronze 5500/50/Dental
Plan IDqhp-95185VA0530006
Plan Year2019
Insurance ProviderKaiser Permanente
Metal LevelExpanded Bronze
Plan TypeHMO
Deductible$5,500
Out-of-Pocket Maximum$7,900
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$50 Copay
Specialist Visit$70 Copay
Laboratory Outpatient and Professional ServicesNot Applicable
X-rays and Diagnostic ImagingNot Applicable
Deductible - Family$11000
Out-of-Pocket Maximum - Family$15800

Prescription drug coverage

Generic Drugs$25 Copay
Preferred Brand Drugs$100 Copay
Non-Preferred Brand Drugs50% Coinsurance after deductible
Specialty Drugs50% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLComing Soon

Hospital services

Emergency Room Services35% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)35% Coinsurance after deductible
Inpatient Physician and Surgical Services35% Coinsurance after deductible

Maternity

Prenatal and Postnatal CareNot Applicable

Mental Health

Mental/Behavioral Health Outpatient ServicesNot Applicable
Mental/Behavioral Health Inpatient Services35.00% Coinsurance after deductible

Vision Coverage

Routine Eye Exam for ChildrenNot Applicable
Eye Glasses for ChildrenNot Applicable

Exclusions and Limitations

More Included BenefitsOther Practitioner Office Visit (Nurse, Physician Assistant)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Hospice Services
Private-Duty Nursing
Urgent Care Centers or Facilities
Home Health Care Services
Inpatient Physician and Surgical Services
Bariatric Surgery
Skilled Nursing Facility
Outpatient Rehabilitation Services
Habilitation Services
Chiropractic Care
Radiation
Diabetes Education
Durable Medical Equipment
Imaging (CT/PET Scans, MRIs)
Preventive Care/Screening/Immunization
Dental Check-Up for Children
Rehabilitative Speech Therapy
Rehabilitative Occupational and Rehabilitative Physical Therapy
Well Baby Visits and Care
Transplant
Accidental Dental
Dialysis
Allergy Testing
Chemotherapy
Prosthetic Devices
Infusion Therapy
Treatment for Temporomandibular Joint Disorders
Nutritional Counseling
Reconstructive Surgery
More Excluded BenefitsInfertility Treatment
Long-Term/Custodial Nursing Home Care
Cosmetic Surgery
Hearing Aids
Routine Foot Care
Acupuncture
Weight Loss Programs
Abortion for Which Public Funding is Prohibited
PremiumPlan NameDeductible
from $1,012
Bronze $10 Copay POS Plan-MOC
$5,600.00Select
from $1,016
Bronze $15 Copay POS Carelink-Southside- MOC
$5,500.00Select
from $1,303
IH AdvantagePlus 5500 PD: MO
$5,500.00Select
from $1,337
Aetna AdvantagePlus 5500 PD: MO
$5,500.00Select
from $141
Bronze $15 Copay POS Carelink-Bon Secours
$5,500.00Select
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  • Phone Number
    (757) 420-6218
  • Office Locations
    6477 College Park Sq
    Virginia Beach, VA 23464
6477 College Park Sq Virginia Beach VA, 23464

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, or an individual and family health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. HealthPocket, Inc. is part of the Health Insurance Innovations, Inc. family of companies (NASDAQ: HIIQ).

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HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, or an individual and family health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. HealthPocket, Inc. is part of the Health Insurance Innovations, Inc. family of companies (NASDAQ: HIIQ).