KP OR Gold 0
Kaiser Foundation Health Plan of the Northwest · 2027 plan year
Gold
- Ind. deductible
- $0
- Family deductible
- $0
- Ind. OOP max
- $10,000
- Family OOP max
- $20,000
Compare with other Gold 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 | $350 | $350 |
| 21 | $551 | $661 |
| 30 | $625 | $751 |
| 40 | $704 | $845 |
| 50 | $984 | $1,181 |
| 60 | $1,496 | $1,795 |
| 64 and over | $1,653 | $1,983 |
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 | $15.00 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $50.00 |
Hospital
| Benefit | In-network |
|---|---|
| Urgent Care Centers or Facilities | $50.00 |
| Emergency Room Services | $350.00 |
| Inpatient Hospital Services (e.g., Hospital Stay) | 30.00% |
| Outpatient Surgery Physician/Surgical Services | 30.00% |
Pharmacy
| Benefit | In-network |
|---|---|
| Generic Drugs | $15.00 |
| Non-Preferred Brand Drugs | 50.00% |
| Preferred Brand Drugs | $40.00 |
| Specialty Drugs | 50.00% |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | 30.00% |
| Mental/Behavioral Health Outpatient Services | $15.00 |
Other
| Benefit | In-network |
|---|---|
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | $50.00 |
| Acupuncture | $25.00 |
| Allergy Testing | $50.00 |
| Chemotherapy | $50.00 |
| Chiropractic Care | $25.00 |
| Cosmetic Surgery | 30.00% |
| Abortion for Which Public Funding is Prohibited | No charge |
| Accidental Dental | 30.00% |
| Delivery and All Inpatient Services for Maternity Care | 30.00% |
| Diabetes Education | $15.00 |
| Dialysis | $50.00 |
| Durable Medical Equipment | 30.00% |
| Emergency Transportation/Ambulance | 30.00% |
| Eye Glasses for Children | No charge |
| Habilitation Services | $50.00 |
| Hearing Aids | 30.00% |
| Home Health Care Services | No charge |
| Hospice Services | No charge |
| Imaging (CT/PET Scans, MRIs) | $350.00 |
| Infusion Therapy | $50.00 |
| Inpatient Physician and Surgical Services | 30.00% |
| Laboratory Outpatient and Professional Services | $40.00 |
| Nutritional Counseling | $15.00 |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $15.00 |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | $350.00 |
| Outpatient Rehabilitation Services | $50.00 |
| Prenatal and Postnatal Care | No charge |
| Prosthetic Devices | 30.00% |
| Radiation | $50.00 |
| Reconstructive Surgery | 30.00% |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $50.00 |
| Rehabilitative Speech Therapy | $50.00 |
| Routine Eye Exam (Adult) | $15.00 |
| Routine Eye Exam for Children | No charge |
| Routine Foot Care | $50.00 |
| Skilled Nursing Facility | 30.00% |
| Substance Abuse Disorder Inpatient Services | 30.00% |
| Substance Abuse Disorder Outpatient Services | $15.00 |
| Telehealth - Primary Care | No charge |
| Telehealth - Specialist | No charge |
| Transplant | 30.00% |
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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