2019 KP Bronze II 30% - PedDent - Fit Plan Details - HealthPocket

KP Bronze II 30% - PedDent - Fit

$380.96/mo

Apply For This Plan

Zip Code96818
Applicant1/22/1984 Male
Coverage Start1/24/2019
Apply Now

Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameKP Bronze II 30% - PedDent - Fit
Plan IDhhs-60612HI0120030
Plan Year2019
Insurance ProviderKaiser Permanente
Metal LevelExpanded Bronze
Plan TypeHMO
Deductible$5,500
Out-of-Pocket Maximum$6,550
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness30.00% Coinsurance after deductible
Specialist Visit30.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services30.00% Coinsurance after deductible
X-rays and Diagnostic Imaging30.00% Coinsurance after deductible
Diagnostic Imaging such as MRIs, CT, and PET scans30.00% Coinsurance after deductible
Deductible - Family$11000 per group
Out-of-Pocket Maximum - Family$13100 per group

Prescription drug coverage

Generic Drugs30.00% Coinsurance after deductible
Preferred Brand Drugs30.00% Coinsurance after deductible
Non-Preferred Brand Drugs30.00% Coinsurance after deductible
Specialty Drugs30.00% Coinsurance after deductible

Access to doctors and hospitals

Provider directory URLhttps://healthy.kaiserpermanente.org/care/doctors-locations/#/search
Does this plan have access to a national provider network?No
Is a referral required to see a Specialist?Yes - Referral required for certain specialists
Does this plan cover services outside plan service area?Yes - Emergency Services, Urgent Care and Authorized Referrals
Does this plan cover services outside the country?Yes - Emergency Services

Hospital services

Emergency Room Services30.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)30.00% Coinsurance after deductible
Inpatient Physician and Surgical Services30.00% Coinsurance after deductible
Emergency Transportation or Ambulance Service30.00% Coinsurance after deductible

Maternity

Prenatal and Postnatal CareNot Applicable
Delivery and all inpatient services for maternity care30.00% Coinsurance after deductible

Mental Health

Mental/Behavioral Health Outpatient Services30.00% Coinsurance after deductible
Mental/Behavioral Health Inpatient Services30.00% Coinsurance after deductible
Substance use disorder outpatient services30.00% Coinsurance after deductible
Substance use disorder inpatient services30.00% 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, Weight Loss Programs
Does this plan offer a wellness program?Included

Vision Coverage

Routine Eye Exam for ChildrenIncluded
Eye Glasses for ChildrenIncluded
Routine Eye Exam for AdultsIncluded

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
Bariatric Surgery
Imaging (CT/PET Scans, MRIs)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Urgent Care Centers or Facilities
Inpatient Physician and Surgical Services
Home Health Care Services
Outpatient Rehabilitation Services
Habilitation Services
Durable Medical Equipment
Hospice Services
Accidental Dental
Allergy Testing
Chemotherapy
Diabetes Education
Dialysis
Infusion Therapy
Laboratory Outpatient and Professional Services
Nutritional Counseling
Prosthetic Devices
Radiation
Reconstructive Surgery
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
Transplant
Treatment for Temporomandibular Joint Disorders
Well Baby Visits and Care
Active & Fit
Specialty Laboratory Services
Testing Services
Active&Fit
Generic Drugs Other
More Limited BenefitsSkilled Nursing Facility
Hearing Aids
Infertility Treatment
Abortion for Which Public Funding is Prohibited
More Excluded BenefitsAcupuncture
Cosmetic Surgery
Long-Term/Custodial Nursing Home Care
Private-Duty Nursing
Weight Loss Programs
Dental Check-Up for Children
Chiropractic Care
Routine Foot Care
PremiumPlan NameDeductible
from $311
KP Bronze II 30% - Fit
$5,500.00Select
from $380
KP Bronze II 30% - Fit
$5,500.00Select
/
Please select the correct zip
Ayon, Dennis
View All Details
Snyder, Marcus
View All Details
Lawson, Marva
View All Details
Washer, Jessica
View All Details
Inouye, Lee
View All Details
Dailey, Shelley
View All Details
Miyaki, Kenson
View All Details
Francis, Matthew
View All Details
Gerrior, Joanne
View All Details
Yang, Thomas
View All Details
Tong, Mary
View All Details
Smith, Cortney
View All Details
Shimoda, Cynthia
View All Details
De Jesus, Caroline
View All Details
Tsuji, Garvin
View All Details
Ogami-glary, Evelyn
View All Details
Moreno, Mary Leslie Joy
View All Details
Pacific Centre For Family Health And Wellness Corp
View All Details
Kurihara, Reyn
View All Details
Dennis Ayon, M.D.
View All Details
  • Phone Number
    (808) 594-7845
  • Office Locations
    5333 Likini St
    Honolulu, HI 96818
5333 Likini St Honolulu HI, 96818

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.

Close

Health Plans Found

 

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.