KP Select CO Silver 80/10/94% CSR

Kaiser Foundation Health Plan of Colorado · 2027 plan year

Silver
Ind. deductible
$80
Family deductible
$160
Ind. OOP max
$3,100
Family OOP max
$6,200

More Kaiser Foundation Health Plan of Colorado plans in CO

Live premium estimate

$

Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness$10.00

Specialist

BenefitIn-network
Specialist Visit$20.00

Hospital

BenefitIn-network
Emergency Room Services10.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)10.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services10.00% Coinsurance after deductible
Urgent Care Centers or Facilities$50.00

Pharmacy

BenefitIn-network
Generic Drugs$5.00
Medical Service Drugs10.00% Coinsurance after deductible
Non-Preferred Brand Drugs10.00%
Non-Preferred Generic Drugs10.00%
Preferred Brand Drugs$10.00
Preventive DrugsNo charge
Specialty Drugs10.00%

Mental Health

BenefitIn-network
Intensive Outpatient for Mental/Behavioral HealthNo charge
Intensive Outpatient for Substance Use DisorderNo charge
Mental Health Wellness VisitNo charge
Mental/Behavioral Health Inpatient Services10.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$10.00
Mental/Behavioral Health Prenatal Care$10.00
Office Visit - Mental/Behavioral Health$10.00
Office Visit - Substance Use Disorder$10.00
Partial Hospitalization for Mental/Behavioral HealthNo charge
Partial Hospitalization for Substance Use DisorderNo charge
Postpartum Mental/Behavioral Health$10.00
Postpartum Substance Use Disorder$10.00
Residential Day Treatment for Mental/Behavioral HealthNo charge
Residential Day Treatment for Substance Use DisorderNo charge
Substance Use Disorder Prenatal Care$10.00
Telehealth Mental/Behavioral HealthNo charge
Telehealth Substance Use DisorderNo charge

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNo charge
Acupuncture$25.00
Allergy Testing$20.00
Applied Behavior Analysis Based Therapies$10.00
Autism Spectrum Disorders - Assessment and Evaluation Services$10.00
Bariatric Surgery10.00% Coinsurance after deductible
Basic Dental Care - Child50.00% Coinsurance after deductible
Chemotherapy10.00% Coinsurance after deductible
Chiropractic Care$25.00
Delivery and All Inpatient Services for Maternity Care10.00% Coinsurance after deductible
Dental Check-Up for ChildrenNo Charge after deductible
Diabetes Education$10.00
Diabetic Supplies20.00%
Dialysis10.00% Coinsurance after deductible
Durable Medical Equipment10.00% Coinsurance after deductible
Emergency Transportation/Ambulance10.00% Coinsurance after deductible
Eye Glasses for Children50.00%
Gender Affirming Care10.00% Coinsurance after deductible
Habilitation Services$10.00
Hearing Aids10.00% Coinsurance after deductible
Home Health Care Services10.00% Coinsurance after deductible
Hospice ServicesNo charge
Imaging (CT/PET Scans, MRIs)10.00% Coinsurance after deductible
Infertility Treatment10.00% Coinsurance after deductible
Infusion Therapy10.00% Coinsurance after deductible
Inpatient Physician and Surgical Services10.00% Coinsurance after deductible
Inpatient Rehabilitation10.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services10.00% Coinsurance after deductible
Major Dental Care - Child50.00% Coinsurance after deductible
Nutritional Counseling$10.00
Other Practitioner Office Visit (Nurse, Physician Assistant)$20.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)10.00% Coinsurance after deductible
Outpatient Rehabilitation Services$10.00
Prenatal and Postnatal Care10.00% Coinsurance after deductible
Private-Duty Nursing10.00% Coinsurance after deductible
Prosthetic Devices10.00% Coinsurance after deductible
Prosthetics: Legs and Arms10.00%
Prosthetics: Recreational10.00%
Radiation10.00% Coinsurance after deductible
Reconstructive Surgery10.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy$10.00
Rehabilitative Occupational Therapy$10.00
Rehabilitative Physical Therapy$10.00
Rehabilitative Speech Therapy$10.00
Routine Eye Exam for Children$10.00
Skilled Nursing Facility10.00% Coinsurance after deductible
Standalone Laboratory10.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services10.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services$10.00
Telehealth PCPNo charge
Telehealth SpecialistNo charge
Transplant10.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders10.00% Coinsurance after deductible
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging10.00% Coinsurance after deductible

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