KP WA 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 WA

Side by side: deductibles, out-of-pocket limits and copays.

More Kaiser Foundation Health Plan of the Northwest plans in WA

Monthly premiums by age

Rating Area 3 — the lowest-priced of the 2 areas this plan covers. Premiums differ by area.

AgeIndividual
Under 15$398
21$520
30$590
40$664
50$928
60$1,411
64 and over$1,559

Live premium estimate

$

Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness$15.00

Specialist

BenefitIn-network
Specialist Visit$50.00

Hospital

BenefitIn-network
Emergency Room Services$350.00
Inpatient Hospital Services (e.g., Hospital Stay)30.00%
Outpatient Surgery Physician/Surgical ServicesNo charge
Urgent Care Centers or Facilities$50.00

Pharmacy

BenefitIn-network
Generic Drugs$15.00
Non-Preferred Brand Drugs50.00%
Preferred Brand Drugs$40.00
Specialty Drugs50.00%

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services30.00%
Mental/Behavioral Health Outpatient Services$15.00

Other

BenefitIn-network
Durable Medical Equipment30.00%
Emergency Transportation/Ambulance30.00%
Eye Glasses for ChildrenNo charge
Gender Affirming Care30.00%
Habilitation Services$50.00
Hearing Aids30.00%
Hearing Exams$50.00
Home Health Care ServicesNo charge
Hospice ServicesNo charge
Imaging (CT/PET Scans, MRIs)$350.00
Infertility Treatment50.00%
Infusion Therapy$50.00
Inherited Metabolic Disorder - PKU30.00%
Inpatient Physician and Surgical Services30.00%
Laboratory Outpatient and Professional Services$40.00
Nutritional Counseling$15.00
Abortion for Which Public Funding is ProhibitedNo charge
Acupuncture$50.00
Allergy Testing$50.00
Chemotherapy$50.00
Chiropractic Care$50.00
Cosmetic Surgery30.00%
Delivery and All Inpatient Services for Maternity Care30.00%
Dental Anesthesia30.00%
Diabetes Care Management$15.00
Diabetes Education$15.00
Dialysis$50.00
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 CareNo charge
Prosthetic Devices30.00%
Radiation$50.00
Reconstructive Surgery30.00%
Rehabilitative Occupational and Rehabilitative Physical Therapy$50.00
Rehabilitative Speech Therapy$50.00
Routine Eye Exam (Adult)$15.00
Routine Eye Exam for ChildrenNo charge
Routine Foot Care$50.00
Skilled Nursing Facility30.00%
Substance Abuse Disorder Inpatient Services30.00%
Substance Abuse Disorder Outpatient Services$15.00
Transplant30.00%
Treatment for Temporomandibular Joint Disorders$50.00
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging$50.00

Service area

This plan covers 2 geographic areas.

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