KP CO Silver 4500/35 RX Copay - AI/LTD

Kaiser Foundation Health Plan of Colorado · 2027 plan year

Silver

Ind. deductible: $4,500
Family deductible: $9,000
Ind. OOP max: $10,150
Family OOP max: $20,300

Other cost-sharing reduction variants for this plan:

73% AV Level Silver Plan 87% AV Level Silver Plan 94% AV Level Silver Plan 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 2500/35 KP Select CO Silver 4500/35 RX Copay

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	$35.00

Specialist

Benefit	In-network
Specialist Visit	$90.00

Hospital

Benefit	In-network
Emergency Room Services	40.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	40.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services	40.00% Coinsurance after deductible
Urgent Care Centers or Facilities	$100.00

Pharmacy

Benefit	In-network
Generic Drugs	$15.00
Medical Service Drugs	$700.00
Non-Preferred Brand Drugs	$400.00
Non-Preferred Generic Drugs	$400.00
Preferred Brand Drugs	$100.00
Preventive Drugs	No charge
Specialty Drugs	$700.00

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	40.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services	$35.00
Mental/Behavioral Health Prenatal Care	$35.00
Office Visit - Mental/Behavioral Health	$35.00
Office Visit - Substance Use Disorder	$35.00
Partial Hospitalization for Mental/Behavioral Health	No charge
Partial Hospitalization for Substance Use Disorder	No charge
Postpartum Mental/Behavioral Health	$35.00
Postpartum Substance Use Disorder	$35.00
Residential Day Treatment for Mental/Behavioral Health	No charge
Residential Day Treatment for Substance Use Disorder	No charge
Substance Use Disorder Prenatal Care	$35.00
Telehealth Mental/Behavioral Health	No charge
Telehealth Substance Use Disorder	No charge

Other

Benefit	In-network
Outpatient Rehabilitation Services	$50.00
Abortion for Which Public Funding is Prohibited	No charge
Acupuncture	$50.00
Allergy Testing	$90.00
Applied Behavior Analysis Based Therapies	$35.00
Autism Spectrum Disorders - Assessment and Evaluation Services	$35.00
Bariatric Surgery	40.00% Coinsurance after deductible
Basic Dental Care - Child	50.00% Coinsurance after deductible
Chemotherapy	$700.00
Chiropractic Care	$50.00
Delivery and All Inpatient Services for Maternity Care	40.00% Coinsurance after deductible
Dental Check-Up for Children	No Charge after deductible
Diabetes Education	$35.00
Diabetic Supplies	20.00%
Dialysis	40.00% Coinsurance after deductible
Durable Medical Equipment	40.00% Coinsurance after deductible
Emergency Transportation/Ambulance	40.00% Coinsurance after deductible
Eye Glasses for Children	50.00%
Gender Affirming Care	40.00% Coinsurance after deductible
Habilitation Services	$50.00
Hearing Aids	40.00% Coinsurance after deductible
Home Health Care Services	40.00% Coinsurance after deductible
Hospice Services	No charge
Imaging (CT/PET Scans, MRIs)	40.00% Coinsurance after deductible
Infertility Treatment	40.00% Coinsurance after deductible
Infusion Therapy	$700.00
Inpatient Physician and Surgical Services	40.00% Coinsurance after deductible
Inpatient Rehabilitation	40.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services	40.00% Coinsurance after deductible
Major Dental Care - Child	50.00% Coinsurance after deductible
Nutritional Counseling	$35.00
Other Practitioner Office Visit (Nurse, Physician Assistant)	$90.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)	40.00% Coinsurance after deductible
Prenatal and Postnatal Care	40.00% Coinsurance after deductible
Private-Duty Nursing	40.00% Coinsurance after deductible
Prosthetic Devices	40.00% Coinsurance after deductible
Prosthetics: Legs and Arms	20.00%
Prosthetics: Recreational	20.00%
Radiation	40.00% Coinsurance after deductible
Reconstructive Surgery	40.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy	$50.00
Rehabilitative Occupational Therapy	$50.00
Rehabilitative Physical Therapy	$50.00
Rehabilitative Speech Therapy	$50.00
Routine Eye Exam for Children	$35.00
Skilled Nursing Facility	40.00% Coinsurance after deductible
Standalone Laboratory	40.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services	40.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services	$35.00
Telehealth PCP	No charge
Telehealth Specialist	No charge
Transplant	40.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders	40.00% Coinsurance after deductible
Well Baby Visits and Care	No charge
X-rays and Diagnostic Imaging	40.00% Coinsurance after deductible

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