KP OR Silver 4000
Kaiser Foundation Health Plan of the Northwest · 2027 plan year
Silver
- Ind. deductible
- $4,000
- Family deductible
- $8,000
- Ind. OOP max
- $10,000
- Family OOP max
- $20,000
Compare with other Silver plans in OR
Side by side: deductibles, out-of-pocket limits and copays.
Other cost-sharing reduction variants for this plan:
More Kaiser Foundation Health Plan of the Northwest plans in OR
Monthly premiums by age
Rating Area 1 — the lowest-priced of the 5 areas this plan covers. Premiums differ by area.
| Age | Individual | Individual + tobacco |
|---|---|---|
| Under 15 | $304 | $304 |
| 21 | $479 | $575 |
| 30 | $543 | $652 |
| 40 | $612 | $734 |
| 50 | $855 | $1,026 |
| 60 | $1,299 | $1,559 |
| 64 and over | $1,437 | $1,725 |
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 | $40.00 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $70.00 |
Hospital
| Benefit | In-network |
|---|---|
| Urgent Care Centers or Facilities | $70.00 |
| Emergency Room Services | $350.00 Copay after deductible |
| Inpatient Hospital Services (e.g., Hospital Stay) | 35.00% Coinsurance after deductible |
| Outpatient Surgery Physician/Surgical Services | 35.00% Coinsurance after deductible |
Pharmacy
| Benefit | In-network |
|---|---|
| Generic Drugs | $25.00 |
| Non-Preferred Brand Drugs | 50.00% Coinsurance after deductible |
| Preferred Brand Drugs | $75.00 |
| Specialty Drugs | 50.00% Coinsurance after deductible |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | 35.00% Coinsurance after deductible |
| Mental/Behavioral Health Outpatient Services | $40.00 |
Other
| Benefit | In-network |
|---|---|
| Accidental Dental | 35.00% Coinsurance after deductible |
| Acupuncture | $25.00 |
| Allergy Testing | $70.00 |
| Chemotherapy | $70.00 |
| Chiropractic Care | $25.00 |
| Cosmetic Surgery | 35.00% Coinsurance after deductible |
| Telehealth - Specialist | No charge |
| Transplant | 35.00% Coinsurance after deductible |
| Well Baby Visits and Care | No charge |
| Abortion for Which Public Funding is Prohibited | No charge |
| Delivery and All Inpatient Services for Maternity Care | 35.00% Coinsurance after deductible |
| Diabetes Education | $40.00 |
| Dialysis | $70.00 |
| Durable Medical Equipment | 35.00% Coinsurance after deductible |
| Emergency Transportation/Ambulance | 35.00% Coinsurance after deductible |
| Eye Glasses for Children | No charge |
| Habilitation Services | $70.00 |
| Hearing Aids | 35.00% |
| Home Health Care Services | 35.00% Coinsurance after deductible |
| Hospice Services | No charge |
| Imaging (CT/PET Scans, MRIs) | $350.00 Copay after deductible |
| Infusion Therapy | $70.00 |
| Inpatient Physician and Surgical Services | 35.00% Coinsurance after deductible |
| Laboratory Outpatient and Professional Services | $60.00 |
| Nutritional Counseling | $40.00 |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $40.00 |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | 35.00% Coinsurance after deductible |
| Outpatient Rehabilitation Services | $70.00 |
| Prenatal and Postnatal Care | No charge |
| Prosthetic Devices | 35.00% Coinsurance after deductible |
| Radiation | $70.00 |
| Reconstructive Surgery | 35.00% Coinsurance after deductible |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $70.00 |
| Rehabilitative Speech Therapy | $70.00 |
| Routine Eye Exam for Children | No charge |
| Routine Foot Care | $70.00 |
| Skilled Nursing Facility | 35.00% Coinsurance after deductible |
| Substance Abuse Disorder Inpatient Services | 35.00% Coinsurance after deductible |
| Substance Abuse Disorder Outpatient Services | $40.00 |
| Telehealth - Primary Care | No charge |
| X-rays and Diagnostic Imaging | $60.00 Copay after deductible |
Service area
This plan covers 56 geographic areas. 49 of them are covered only in part, meaning specific ZIP codes rather than the whole county. The filing does not list which, so confirm with the insurer or on HealthCare.gov before enrolling.
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