2019 KP Platinum $10 - Fit Plan Details - HealthPocket

KP Platinum $10 - Fit

$493.00/mo

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Zip Code96818
Applicant11/15/1983 Male
Coverage Start11/17/2018
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameKP Platinum $10 - Fit
Plan IDqhp-60612HI0110001
Plan Year2019
Insurance ProviderKaiser Permanente
Metal LevelPlatinum
Plan TypeHMO
Deductible$0
Out-of-Pocket Maximum$5,000
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$10 Copay
Specialist Visit$20 Copay
Laboratory Outpatient and Professional ServicesNot Applicable
X-rays and Diagnostic ImagingNot Applicable
Deductible - Family$0
Out-of-Pocket Maximum - Family$10000

Prescription drug coverage

Generic Drugs$3 Copay
Preferred Brand Drugs$45 Copay
Non-Preferred Brand Drugs$45 Copay
Specialty Drugs$200 Copay

Access to doctors and hospitals

Provider directory URLComing Soon

Hospital services

Emergency Room Services$250 Copay
Inpatient Hospital Services (e.g., Hospital Stay)$300 Copay
Inpatient Physician and Surgical ServicesNo Charge

Maternity

Prenatal and Postnatal CareNot Applicable

Mental Health

Mental/Behavioral Health Outpatient ServicesNot Applicable
Mental/Behavioral Health Inpatient ServicesNot Applicable

Vision Coverage

Routine Eye Exam for ChildrenNot Applicable
Eye Glasses for ChildrenNot Applicable

Exclusions and Limitations

More Included BenefitsPreventive Care/Screening/Immunization
Rehabilitative Speech Therapy
Rehabilitative Occupational and Rehabilitative Physical Therapy
Other Practitioner Office Visit (Nurse, Physician Assistant)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Hospice Services
Infertility Treatment
Urgent Care Centers or Facilities
Home Health Care Services
Inpatient Physician and Surgical Services
Bariatric Surgery
Skilled Nursing Facility
Outpatient Rehabilitation Services
Habilitation Services
Durable Medical Equipment
Hearing Aids
Imaging (CT/PET Scans, MRIs)
Well Baby Visits and Care
Abortion for Which Public Funding is Prohibited
Transplant
Accidental Dental
Dialysis
Allergy Testing
Chemotherapy
Radiation
Diabetes Education
Prosthetic Devices
Infusion Therapy
Treatment for Temporomandibular Joint Disorders
Nutritional Counseling
Reconstructive Surgery
Generic Drugs Other
Specialty Laboratory Services
Testing Services
Active & Fit
Adult Optical (hardware)
More Excluded BenefitsRoutine Foot Care
Acupuncture
Weight Loss Programs
Dental Check-Up for Children
Long-Term/Custodial Nursing Home Care
Private-Duty Nursing
Cosmetic Surgery
Chiropractic Care
PremiumPlan NameDeductible
from $390
HMSA Gold PPO
$0.00Select
from $430
KP Gold I $30 - Fit
$0.00Select
from $434
KP Gold I $30 - ChiroAcuMassage - Fit
$0.00Select
from $435
HMSA Platinum PPO
$0.00Select
from $440
HMSA Platinum HMO
$0.00Select
  • What is the Platinum Plan?

    ObamaCare’s Platinum Plan is a type of Metal Plan on the Health Insurance Marketplace. Platinum Plans qualify for Tax Credits and have the highest premiums. A Platinum Plan is designed to incur the lowest out-of-pocket expenses for enrollees. A typical platinum plan enrollee pays approximately 10% of the costs of covered healthcare services with the plan paying the remainder. In comparison, a typical Bronze Plan enrollee pays 40% of covered medical expenses.

  • How are Platinum 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 Platinum Plan pays 90% of covered medical costs for a typical enrollee while the other Obamacare health plans pay a lower percentage of these costs.

  • How much does a Platinum Plan cost?

    The monthly premium for a Platinum 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 Platinum Plan premiums in your area.

  • When Can I Enroll in a Platinum 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, Medicaid or an individual 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.

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HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual 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.