KP OR Silver 3000/20%HSA Plan Details for 2021- HealthPocket

KP OR Silver 3000/20%HSA

$414.00/mo

Apply For This Plan

Zip Code97229
Applicant6/13/1986 Male
Apply Now

Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameKP OR Silver 3000/20%HSA
Plan IDhhs-71287OR0420013
Plan Year2021
Insurance ProviderKaiser Permanente
Metal LevelSilver
Plan TypeEPO
Deductible$3,000
Out-of-Pocket Maximum$6,900
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness20.00% Coinsurance after deductible
Specialist Visit20.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services20.00% Coinsurance after deductible
X-rays and Diagnostic Imaging20.00% Coinsurance after deductible
Diagnostic Imaging such as MRIs, CT, and PET scans20.00% Coinsurance after deductible
Deductible - Family$6000 per group
Out-of-Pocket Maximum - Family$13800 per group

Prescription drug coverage

Generic Drugs$15 Copay after deductible
Preferred Brand Drugs$55 Copay after deductible
Non-Preferred Brand Drugs50.00% Coinsurance after deductible
Specialty Drugs50.00% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLhttps://healthy.kaiserpermanente.org/health/care/consumer/locate-our-services/doctors-and-locations
Does this plan have access to a national provider network?No
Is a referral required to see a Specialist?Yes - A referral is not required for outpatient Services provided in the following departments: Cancer Counseling, Chemical Dependency Services., Mental Health Services., Obstetrics/Gynecology, Occupational Health., Ophthalmology, and Optometry (routine eye exams), and Social Services.
Does this plan cover services outside plan service area?Yes - Emergency medical conditions, including prescription drugs. Out of Area Dependent; 20% Coinsurance of the actual fee charged; Allowance of 5 office visits, 5 Diagnostic Xrays and 5 prescriptions
Does this plan cover services outside the country?Yes - Emergency medical conditions, including prescription drugs

Hospital services

Emergency Room Services20.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)20.00% Coinsurance after deductible
Inpatient Physician and Surgical Services20.00% Coinsurance after deductible
Emergency Transportation or Ambulance Service20.00% Coinsurance after deductible

Maternity

Prenatal and Postnatal Care$0 Copay
Delivery and all inpatient services for maternity care20.00% Coinsurance after deductible

Mental Health

Mental/Behavioral Health Outpatient Services20.00% Coinsurance after deductible
Mental/Behavioral Health Inpatient Services20.00% Coinsurance after deductible
Substance use disorder outpatient services20.00% Coinsurance after deductible
Substance use disorder inpatient services20.00% Coinsurance after deductible

Medical Management Programs

Does this plan offer disease managment programs?Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy
Does this plan offer a wellness program?Included

Vision Coverage

Routine Eye Exam for ChildrenIncluded
Eye Glasses for ChildrenIncluded
Routine Eye Exam for AdultsNot Covered

Child Dental Coverage

Child Dental Coverage - Routine Dental CareNot Covered
Child Dental Coverage - Basic Dental CareNot Covered
Child Dental Coverage - OrthodontiaNot Covered
Child Dental Coverage - Major Dental CareNot Covered

Adult Dental Coverage

Adult Dental Coverage - Routine Dental CareNot Covered
Adult Dental Coverage - Basic Dental CareNot Covered
Adult Dental Coverage - OrthodontiaNot Covered
Adult Dental Coverage - Major Dental CareNot Covered

Exclusions and Limitations

More Included BenefitsOther Practitioner Office Visit (Nurse, Physician Assistant)
Preventive Care/Screening/Immunization
Acupuncture
Cosmetic Surgery
Imaging (CT/PET Scans, MRIs)
Outpatient Surgery Physician/Surgical Services
Urgent Care Centers or Facilities
Inpatient Physician and Surgical Services
Home Health Care Services
Durable Medical Equipment
Hospice Services
Chiropractic Care
Routine Foot Care
Abortion for Which Public Funding is Prohibited
Accidental Dental
Allergy Testing
Chemotherapy
Dialysis
Infusion Therapy
Laboratory Outpatient and Professional Services
Prosthetic Devices
Radiation
Reconstructive Surgery
Transplant
Well Baby Visits and Care
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
More Limited BenefitsSkilled Nursing Facility
Hearing Aids
Outpatient Rehabilitation Services
Habilitation Services
Diabetes Education
Nutritional Counseling
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
More Excluded BenefitsBariatric Surgery
Infertility Treatment
Private-Duty Nursing
Weight Loss Programs
Dental Check-Up for Children
Treatment for Temporomandibular Joint Disorders
Long-Term/Custodial Nursing Home Care
PremiumPlan NameDeductible
from $452Silver HDHP 3000 EPO Individual and Family Network$3,000.00Select
from $458Navigator Silver 3000$3,000.00Select
from $520SmartChoice Silver 3000$3,000.00Select
/
Please select the correct zip
Marilyn, Webber
View All Details
Laura, Hardebeck
View All Details
Gary, Geddes
View All Details
Cynthia, Romero
View All Details
Barbara, Liebowitz
View All Details
Hadi Farah, Md, Llc
View All Details
Dakota, Stewart
View All Details
Sports Health Northwest Inc
View All Details
Naviatric Llc
View All Details
Tracy, Hill
View All Details
Roberta, Mckenney
View All Details
Ryan, Ross
View All Details
Alexandra, Lodwig
View All Details
Keri-kamryn, Skjei
View All Details
Madeleine, Knutson
View All Details
Mariah, Frank
View All Details
Vernon, Rasmussen
View All Details
Charles, Gregory
View All Details
Amanda, Gangstead
View All Details
April, Henderson
View All Details
Katherine, Rinella
View All Details
Adam, Howrey
View All Details
Marilyn Webber, M.D.
View All Details
  • Phone Number
    (503) 629-0237
  • Office Locations
    14223 Nw Spruceridge Ln
    Portland, OR 97229
14223 Nw Spruceridge Ln Portland OR, 97229
  • What Is the Silver Plan?

    ObamaCare’s Silver Plan is a type of Metal Plan on the Health Insurance Marketplace. Silver Plans qualify for both Tax Credits and Cost Sharing subsidies.Silver Plans have lower out-of-pocket costs than Bronze Plans but higher out- of-pocket costs than both Gold and Platinum Plans. All Silver Plans share the same minimum health benefits, but the way they charge out-of-pocket costs can differ significantly.

  • How are Silver Plans different than other Obamacare health plans?

    The fundamental difference among the new Obamacare health plans is the percentage of covered medical costs paid by the health plan. The Silver Plan pays 70% of covered medical costs for a typical enrollee. Silver Plans are also the only metal plans which offer cost-sharing reduction (CSR) versions to consumers that require financial assistance for out-of-pocket costs.

  • How much does a Silver Plan cost?

    The monthly premium for a Silver Plan depends on the insurer from whom you purchase the plan, the number of people to be insured by the plan, your age, whether you smoke, and the region in which you live. You can use HealthPocket’s comparison tool to compare Silver Plan premiums in your area.

  • When Can I Enroll in a Silver Plan?

    The Open Enrollment period for the 2018 Affordable Care Act health plans begins November 1, 2017 and ends December 15, 2017. See our Open Enrollment article for more information.

Read More

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 Benefytt Technologies, Inc. family of companies.

Health Plans Found

 

HealthPocket.com provides information on insurance products. If you choose to obtain a quote or apply for an insurance plan, you may be transferred to a partner website to complete your request. Always review the privacy and terms of use of the partner website.

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 Benefytt Technologies, Inc. family of companies.