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 Oregon Standard Silver Plan

Kaiser Foundation Health Plan of the Northwest · 2027 plan year

Silver
Ind. medical deductible
$6,100
Rx deductible (separate)
$0
Family deductible
$12,200
Ind. OOP max
$10,700
Family OOP max
$21,400

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

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.

AgeIndividualIndividual + tobacco
Under 15$298$298
21$469$563
30$532$639
40$599$719
50$838$1,005
60$1,273$1,528
64 and over$1,407$1,689

Live premium estimate

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Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness$40.00

Specialist

BenefitIn-network
Specialist Visit$100.00

Hospital

BenefitIn-network
Emergency Room Services30.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)30.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services30.00% Coinsurance after deductible
Urgent Care Centers or Facilities$70.00

Pharmacy

BenefitIn-network
Generic Drugs$15.00
Non-Preferred Brand Drugs50.00%
Preferred Brand Drugs$60.00
Specialty Drugs50.00%

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services30.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$40.00

Other

BenefitIn-network
Hospice Services30.00% Coinsurance after deductible
Abortion for Which Public Funding is ProhibitedNo charge
Accidental Dental30.00% Coinsurance after deductible
Acupuncture$40.00
Allergy Testing30.00% Coinsurance after deductible
Chemotherapy30.00% Coinsurance after deductible
Chiropractic Care$40.00
Cosmetic Surgery30.00% Coinsurance after deductible
Delivery and All Inpatient Services for Maternity Care30.00% Coinsurance after deductible
Diabetes EducationNo charge
Dialysis30.00% Coinsurance after deductible
Durable Medical Equipment30.00% Coinsurance after deductible
Emergency Transportation/Ambulance30.00% Coinsurance after deductible
Eye Glasses for ChildrenNo charge
Habilitation Services$40.00
Hearing Aids30.00%
Home Health Care Services30.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)30.00% Coinsurance after deductible
Infusion Therapy30.00% Coinsurance after deductible
Inpatient Physician and Surgical Services30.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services30.00% Coinsurance after deductible
Nutritional CounselingNo charge
Other Practitioner Office Visit (Nurse, Physician Assistant)$40.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)30.00% Coinsurance after deductible
Outpatient Rehabilitation Services$40.00
Prenatal and Postnatal Care30.00% Coinsurance after deductible
Prosthetic Devices30.00% Coinsurance after deductible
Radiation30.00% Coinsurance after deductible
Reconstructive Surgery30.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy$40.00
Rehabilitative Speech Therapy$40.00
Routine Eye Exam for ChildrenNo charge
Routine Foot Care30.00% Coinsurance after deductible
Skilled Nursing Facility30.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services30.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services$40.00
Telehealth - Primary Care$40.00
Telehealth - Specialist$100.00
Transplant30.00% Coinsurance after deductible
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging30.00% Coinsurance 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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