Sold outside the marketplace. This plan is bought directly from the insurer, so it is not eligible for a premium tax credit. If your income qualifies you for savings, a marketplace plan at the same price will usually cost you less.

KP HI Gold 1000 Ded/250 Rx Ded

Kaiser Permanente · 2026 plan year

Gold
Ind. medical deductible
$1,000
Rx deductible (separate)
$250
Family deductible
$2,000
Ind. OOP max
$8,700
Family OOP max
$17,400

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

More Kaiser Permanente plans in HI

Monthly premiums by age

Rating Area 1

AgeIndividualIndividual + tobacco
Under 15$340$340
21$444$533
30$504$605
40$568$681
50$794$952
60$1,206$1,447
64 and over$1,333$1,600

Live premium estimate

$

Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness$30.00

Specialist

BenefitIn-network
Specialist Visit$70.00

Hospital

BenefitIn-network
Emergency Room Services$350.00 Copay after deductible
Inpatient Hospital Services (e.g., Hospital Stay)30.00%
Outpatient Surgery Physician/Surgical Services30.00%
Urgent Care Centers or Facilities$30.00

Pharmacy

BenefitIn-network
Generic Drugs$10.00
Generic Drugs Maintenance$3.00
Non-Preferred Brand Drugs30.00% Coinsurance after deductible
Preferred Brand Drugs30.00% Coinsurance after deductible
Specialty Drugs30.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services30.00%
Mental/Behavioral Health Outpatient Services$30.00

Other

BenefitIn-network
Abortion for Which Public Funding is Prohibited30.00%
Accidental Dental$350.00 Copay after deductible
Active & Fit$200.00
AcupunctureNot covered
Allergy Testing$30.00
Bariatric Surgery30.00%
Basic Dental Care - AdultNot covered
Basic Dental Care - ChildNot covered
Chemotherapy20.00%
Chiropractic CareNot covered
Cosmetic SurgeryNot covered
Delivery and All Inpatient Services for Maternity Care30.00%
Dental Check-Up for ChildrenNot covered
Diabetes Education$30.00
Dialysis20.00%
Durable Medical Equipment20.00%
Emergency Transportation/Ambulance20.00%
Eye Glasses for ChildrenNo charge
Prosthetic Devices30.00%
Radiation20.00%
Reconstructive Surgery30.00%
Habilitation Services$40.00
Hearing Aids60.00%
Home Health Care ServicesNo charge
Hospice ServicesNo charge
Imaging (CT/PET Scans, MRIs)$350.00 Copay after deductible
Infertility Treatment$30.00 + 20.00%
Infusion Therapy20.00%
Inpatient Physician and Surgical Services30.00%
Laboratory Outpatient and Professional Services$40.00
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - ChildNot covered
Nutritional CounselingNo charge
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Other Practitioner Office Visit (Nurse, Physician Assistant)$30.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)30.00%
Outpatient Rehabilitation Services$40.00
Prenatal and Postnatal CareNo charge
Private-Duty NursingNot covered
Rehabilitative Occupational and Rehabilitative Physical Therapy$40.00
Rehabilitative Speech Therapy$40.00
Routine Dental Services (Adult)Not covered
Routine Eye Exam (Adult)$30.00
Routine Eye Exam for ChildrenNo charge
Routine Foot CareNot covered
Skilled Nursing Facility30.00% Coinsurance after deductible
Specialty Laboratory Services$350.00 Copay after deductible
Substance Abuse Disorder Inpatient Services30.00%
Substance Abuse Disorder Outpatient Services$30.00
Testing Services$15.00
Transplant30.00%
Treatment for Temporomandibular Joint Disorders30.00%
Weight Loss ProgramsNot covered
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging$40.00

Service area

This plan covers 1 geographic area.

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