KP CO Silver 3900/25/73% CSR

Kaiser Foundation Health Plan of Colorado · 2027 plan year

Silver
Ind. deductible
$3,900
Family deductible
$7,800
Ind. OOP max
$8,500
Family OOP max
$17,000

More Kaiser Foundation Health Plan of Colorado plans in CO

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$25.00

Specialist

BenefitIn-network
Specialist Visit$80.00

Hospital

BenefitIn-network
Emergency Room Services35.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)35.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services35.00% Coinsurance after deductible
Urgent Care Centers or Facilities$100.00

Pharmacy

BenefitIn-network
Generic Drugs$15.00
Medical Service Drugs35.00% Coinsurance after deductible
Non-Preferred Brand Drugs35.00% Coinsurance after deductible
Non-Preferred Generic Drugs35.00% Coinsurance after deductible
Preferred Brand Drugs$65.00
Preventive DrugsNo charge
Specialty Drugs35.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Intensive Outpatient for Mental/Behavioral HealthNo charge
Intensive Outpatient for Substance Use DisorderNo charge
Mental Health Wellness VisitNo charge
Mental/Behavioral Health Inpatient Services35.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$25.00
Mental/Behavioral Health Prenatal Care$25.00
Office Visit - Mental/Behavioral Health$25.00
Office Visit - Substance Use Disorder$25.00
Partial Hospitalization for Mental/Behavioral HealthNo charge
Partial Hospitalization for Substance Use DisorderNo charge
Postpartum Mental/Behavioral Health$25.00
Postpartum Substance Use Disorder$25.00
Residential Day Treatment for Mental/Behavioral HealthNo charge
Residential Day Treatment for Substance Use DisorderNo charge
Substance Use Disorder Prenatal Care$25.00
Telehealth Mental/Behavioral HealthNo charge
Telehealth Substance Use DisorderNo charge

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNo charge
Acupuncture$45.00
Allergy Testing$80.00
Applied Behavior Analysis Based Therapies$25.00
Autism Spectrum Disorders - Assessment and Evaluation Services$25.00
Bariatric Surgery35.00% Coinsurance after deductible
Basic Dental Care - Child50.00% Coinsurance after deductible
Chemotherapy35.00% Coinsurance after deductible
Chiropractic Care$45.00
Delivery and All Inpatient Services for Maternity Care35.00% Coinsurance after deductible
Dental Check-Up for ChildrenNo Charge after deductible
Diabetes Education$25.00
Diabetic Supplies20.00%
Dialysis35.00% Coinsurance after deductible
Durable Medical Equipment35.00% Coinsurance after deductible
Emergency Transportation/Ambulance35.00% Coinsurance after deductible
Eye Glasses for Children50.00%
Gender Affirming Care35.00% Coinsurance after deductible
Habilitation Services$25.00
Hearing Aids35.00% Coinsurance after deductible
Home Health Care Services35.00% Coinsurance after deductible
Hospice ServicesNo charge
Imaging (CT/PET Scans, MRIs)35.00% Coinsurance after deductible
Infertility Treatment35.00% Coinsurance after deductible
Infusion Therapy35.00% Coinsurance after deductible
Inpatient Physician and Surgical Services35.00% Coinsurance after deductible
Inpatient Rehabilitation35.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services35.00% Coinsurance after deductible
Major Dental Care - Child50.00% Coinsurance after deductible
Nutritional Counseling$25.00
Other Practitioner Office Visit (Nurse, Physician Assistant)$80.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)35.00% Coinsurance after deductible
Outpatient Rehabilitation Services$25.00
Prenatal and Postnatal Care35.00% Coinsurance after deductible
Private-Duty Nursing35.00% Coinsurance after deductible
Prosthetic Devices35.00% Coinsurance after deductible
Prosthetics: Legs and Arms20.00%
Prosthetics: Recreational20.00%
Radiation35.00% Coinsurance after deductible
Reconstructive Surgery35.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy$25.00
Rehabilitative Occupational Therapy$25.00
Rehabilitative Physical Therapy$25.00
Rehabilitative Speech Therapy$25.00
Routine Eye Exam for Children$25.00
Skilled Nursing Facility35.00% Coinsurance after deductible
Standalone Laboratory35.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services35.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services$25.00
Telehealth PCPNo charge
Telehealth SpecialistNo charge
Transplant35.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders35.00% Coinsurance after deductible
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging35.00% Coinsurance after deductible

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