KP Select CO Silver 2500/30/73% CSR

Kaiser Foundation Health Plan of Colorado · 2027 plan year

Silver

Ind. medical deductible: $2,500
Rx deductible (separate): $875
Family deductible: $5,000
Ind. OOP max: $8,750
Family OOP max: $17,500

This plan sets a separate deductible for prescription drugs. The medical deductible shown does not cover prescriptions; they have their own.

Other cost-sharing reduction variants for this plan:

87% AV Level Silver Plan 94% AV Level Silver Plan Limited Cost Sharing Plan Variation Standard Silver Off Exchange Plan Standard Silver On Exchange Plan Zero Cost Sharing Plan Variation

More Kaiser Foundation Health Plan of Colorado plans in CO

KP Colorado Option Bronze KP Select CO Gold 0/30 RX Copay KP Select CO Gold 1500/25 KP Select CO Silver 4500/35 RX Copay KP Select CO Silver 3800/25%/HSA

Live premium estimate

Benefits & cost sharing

Primary Care

Benefit	In-network
Preventive Care/Screening/Immunization	No charge
Primary Care Visit to Treat an Injury or Illness	$30.00

Specialist

Benefit	In-network
Specialist Visit	$55.00

Hospital

Benefit	In-network
Inpatient Hospital Services (e.g., Hospital Stay)	35.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services	35.00% Coinsurance after deductible
Urgent Care Centers or Facilities	$100.00
Emergency Room Services	35.00% Coinsurance after deductible

Pharmacy

Benefit	In-network
Medical Service Drugs	35.00% Coinsurance after deductible
Non-Preferred Brand Drugs	35.00% Coinsurance after deductible
Non-Preferred Generic Drugs	35.00% Coinsurance after deductible
Preferred Brand Drugs	$85.00 Copay after deductible
Preventive Drugs	No charge
Specialty Drugs	35.00% Coinsurance after deductible
Generic Drugs	$20.00

Mental Health

Benefit	In-network
Intensive Outpatient for Mental/Behavioral Health	No charge
Intensive Outpatient for Substance Use Disorder	No charge
Mental Health Wellness Visit	No charge
Mental/Behavioral Health Inpatient Services	35.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services	$30.00
Mental/Behavioral Health Prenatal Care	$30.00
Office Visit - Mental/Behavioral Health	$30.00
Office Visit - Substance Use Disorder	$30.00
Partial Hospitalization for Mental/Behavioral Health	No charge
Partial Hospitalization for Substance Use Disorder	No charge
Postpartum Mental/Behavioral Health	$30.00
Postpartum Substance Use Disorder	$30.00
Residential Day Treatment for Mental/Behavioral Health	No charge
Residential Day Treatment for Substance Use Disorder	No charge
Substance Use Disorder Prenatal Care	$30.00
Telehealth Mental/Behavioral Health	No charge
Telehealth Substance Use Disorder	No charge

Other

Benefit	In-network
Abortion for Which Public Funding is Prohibited	No charge
Acupuncture	$45.00
Allergy Testing	$55.00
Applied Behavior Analysis Based Therapies	$30.00
Autism Spectrum Disorders - Assessment and Evaluation Services	$30.00
Bariatric Surgery	35.00% Coinsurance after deductible
Basic Dental Care - Child	50.00% Coinsurance after deductible
Chemotherapy	35.00% Coinsurance after deductible
Chiropractic Care	$45.00
Home Health Care Services	35.00% Coinsurance after deductible
Hospice Services	No charge
Imaging (CT/PET Scans, MRIs)	$500.00
Infertility Treatment	35.00% Coinsurance after deductible
Infusion Therapy	35.00% Coinsurance after deductible
Inpatient Physician and Surgical Services	35.00% Coinsurance after deductible
Inpatient Rehabilitation	35.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services	$30.00
Major Dental Care - Child	50.00% Coinsurance after deductible
Nutritional Counseling	$30.00
Other Practitioner Office Visit (Nurse, Physician Assistant)	$55.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	35.00% Coinsurance after deductible
Outpatient Rehabilitation Services	$45.00
Prenatal and Postnatal Care	35.00% Coinsurance after deductible
Private-Duty Nursing	35.00% Coinsurance after deductible
Prosthetic Devices	35.00% Coinsurance after deductible
Prosthetics: Legs and Arms	20.00%
Prosthetics: Recreational	20.00%
Radiation	35.00% Coinsurance after deductible
Reconstructive Surgery	35.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy	$45.00
Rehabilitative Occupational Therapy	$45.00
Rehabilitative Physical Therapy	$45.00
Rehabilitative Speech Therapy	$45.00
Routine Eye Exam for Children	$30.00
Skilled Nursing Facility	35.00% Coinsurance after deductible
Standalone Laboratory	$30.00
Substance Abuse Disorder Inpatient Services	35.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services	$30.00
Telehealth PCP	No charge
Telehealth Specialist	No charge
Transplant	35.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders	35.00% Coinsurance after deductible
Well Baby Visits and Care	No charge
X-rays and Diagnostic Imaging	35.00% Coinsurance after deductible
Delivery and All Inpatient Services for Maternity Care	35.00% Coinsurance after deductible
Dental Check-Up for Children	No Charge after deductible
Diabetes Education	$30.00
Diabetic Supplies	20.00%
Dialysis	35.00% Coinsurance after deductible
Durable Medical Equipment	35.00% Coinsurance after deductible
Emergency Transportation/Ambulance	35.00% Coinsurance after deductible
Eye Glasses for Children	50.00%
Gender Affirming Care	35.00% Coinsurance after deductible
Habilitation Services	$45.00
Hearing Aids	35.00% Coinsurance after deductible

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