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 OR Gold 0
Kaiser Permanente · 2026 plan year
Gold
- Ind. deductible
- $0
- Family deductible
- $0
- Ind. OOP max
- $8,200
- Family OOP max
- $16,400
Other cost-sharing reduction variants for this plan:
More Kaiser Permanente 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 | $300 | $300 |
| 21 | $472 | $567 |
| 30 | $536 | $643 |
| 40 | $604 | $724 |
| 50 | $844 | $1,012 |
| 60 | $1,282 | $1,538 |
| 64 and over | $1,416 | $1,701 |
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 |
|---|---|
| Emergency Room Services | $350.00 |
| Inpatient Hospital Services (e.g., Hospital Stay) | 30.00% |
| Outpatient Surgery Physician/Surgical Services | No charge |
| Urgent Care Centers or Facilities | $40.00 |
Pharmacy
| Benefit | In-network |
|---|---|
| Zero Cost Share Preventive Drugs | Not covered |
| Generic Drugs | $10.00 |
| Medical Service Drugs | Not covered |
| 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 |
|---|---|
| Eye Glasses for Children | No charge |
| Preferred Generic | $10.00 |
| Abortion for Which Public Funding is Prohibited | No charge |
| Accidental Dental | 30.00% |
| Acupuncture | $25.00 |
| Allergy Testing | $50.00 |
| Bariatric Surgery | Not covered |
| Basic Dental Care - Adult | Not covered |
| Basic Dental Care - Child | Not covered |
| Chemotherapy | $50.00 |
| Chiropractic Care | $25.00 |
| Cosmetic Surgery | 30.00% |
| Delivery and All Inpatient Services for Maternity Care | 30.00% |
| Dental Check-Up for Children | Not covered |
| Diabetes Education | $15.00 |
| Dialysis | $50.00 |
| Durable Medical Equipment | 30.00% |
| Emergency Transportation/Ambulance | 30.00% |
| Gender Affirming Care | See plan details |
| Habilitation Services | $50.00 |
| Hearing Aids | 30.00% |
| Home Health Care Services | No charge |
| Hormone Therapy | See plan details |
| Hospice Services | No charge |
| Imaging (CT/PET Scans, MRIs) | $350.00 |
| Infertility Treatment | Not covered |
| Infusion Therapy | $50.00 |
| Inpatient Physician and Surgical Services | 30.00% |
| Laboratory Outpatient and Professional Services | $50.00 |
| Long-Term/Custodial Nursing Home Care | Not covered |
| Major Dental Care - Adult | Not covered |
| Major Dental Care - Child | Not covered |
| Non-Preferred Generic | $10.00 |
| Nutritional Counseling | $15.00 |
| Orthodontia - Adult | Not covered |
| Orthodontia - Child | Not covered |
| 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 |
| Private-Duty Nursing | Not covered |
| 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 Dental Services (Adult) | Not covered |
| 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% |
| Treatment for Temporomandibular Joint Disorders | Not covered |
| Weight Loss Programs | Not covered |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | $50.00 |
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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