KP Oregon Standard Gold Plan
Kaiser Foundation Health Plan of the Northwest · 2027 plan year
Gold
- Ind. medical deductible
- $2,000
- Rx deductible (separate)
- $0
- Family deductible
- $4,000
- Ind. OOP max
- $8,350
- Family OOP max
- $16,700
This plan sets a separate deductible for prescription drugs. The medical deductible shown does not cover prescriptions; they have their own.
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 | $345 | $345 |
| 21 | $543 | $651 |
| 30 | $616 | $739 |
| 40 | $693 | $832 |
| 50 | $969 | $1,163 |
| 60 | $1,472 | $1,767 |
| 64 and over | $1,629 | $1,953 |
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 | $20.00 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $40.00 |
Hospital
| Benefit | In-network |
|---|---|
| Emergency Room Services | 20.00% Coinsurance after deductible |
| Inpatient Hospital Services (e.g., Hospital Stay) | 20.00% Coinsurance after deductible |
| Outpatient Surgery Physician/Surgical Services | 20.00% Coinsurance after deductible |
| Urgent Care Centers or Facilities | $60.00 |
Pharmacy
| Benefit | In-network |
|---|---|
| Generic Drugs | $10.00 |
| Non-Preferred Brand Drugs | 50.00% |
| Preferred Brand Drugs | $30.00 |
| Specialty Drugs | 50.00% |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | 20.00% Coinsurance after deductible |
| Mental/Behavioral Health Outpatient Services | $20.00 |
Other
| Benefit | In-network |
|---|---|
| Abortion for Which Public Funding is Prohibited | No charge |
| Accidental Dental | 20.00% Coinsurance after deductible |
| Acupuncture | $20.00 |
| Allergy Testing | 20.00% Coinsurance after deductible |
| Chemotherapy | 20.00% Coinsurance after deductible |
| Chiropractic Care | $20.00 |
| Cosmetic Surgery | 20.00% Coinsurance after deductible |
| Delivery and All Inpatient Services for Maternity Care | 20.00% Coinsurance after deductible |
| Diabetes Education | No charge |
| Dialysis | 20.00% Coinsurance after deductible |
| Durable Medical Equipment | 20.00% Coinsurance after deductible |
| Emergency Transportation/Ambulance | 20.00% Coinsurance after deductible |
| Eye Glasses for Children | No charge |
| Habilitation Services | $20.00 |
| Hearing Aids | 20.00% |
| Home Health Care Services | 20.00% Coinsurance after deductible |
| Hospice Services | 20.00% Coinsurance after deductible |
| Imaging (CT/PET Scans, MRIs) | 20.00% Coinsurance after deductible |
| Infusion Therapy | 20.00% Coinsurance after deductible |
| Inpatient Physician and Surgical Services | 20.00% Coinsurance after deductible |
| Laboratory Outpatient and Professional Services | 20.00% Coinsurance after deductible |
| Nutritional Counseling | No charge |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $20.00 |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | 20.00% Coinsurance after deductible |
| Outpatient Rehabilitation Services | $20.00 |
| Prenatal and Postnatal Care | 20.00% Coinsurance after deductible |
| Prosthetic Devices | 20.00% Coinsurance after deductible |
| Radiation | 20.00% Coinsurance after deductible |
| Reconstructive Surgery | 20.00% Coinsurance after deductible |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $20.00 |
| Rehabilitative Speech Therapy | $20.00 |
| Routine Eye Exam for Children | No charge |
| Routine Foot Care | 20.00% Coinsurance after deductible |
| Skilled Nursing Facility | 20.00% Coinsurance after deductible |
| Substance Abuse Disorder Inpatient Services | 20.00% Coinsurance after deductible |
| Substance Abuse Disorder Outpatient Services | $20.00 |
| Telehealth - Primary Care | $20.00 |
| Telehealth - Specialist | $40.00 |
| Transplant | 20.00% Coinsurance after deductible |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | 20.00% 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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