Silver Benefits from Kaiser Permanente Individual and Family Health Plans

Oregon Health Insurance
Call 800.884.2343 or
541.434.9613
FAX - 541.284.2994

SILVER DEDUCTIBLE PLANS	KP 1500/30/Rx	KP 2500/30/Rx	KP 3500/30/Rx	KP 5000/30/Rx	KP 7500/30/Rx
Features
Deductible	$1,500	$2,500	$3,500	$5,000	$7,500
Out-of-pocket maximum	$7,500
Benefits	Services not subject to deductible unless otherwise indicated
Preventive Care
Immunizations	No charge
Yearly routine physicals
Well-baby visits
Mammograms
Outpatient services (per visit or procedure)
Primary care office visit	$30 copay
Specialty office visit	30% coinsurance (after deductible)
Nurse treatment visit (includes allergy injections)¹
Outpatient surgery²
Lab tests and X-rays²
Inpatient hospital care
Inpatient care (including maternity)	30% coinsurance (after deductible)
Maximum per admittance	None
Maternity coverage
Prenatal care (applies to prenatal office visits, one postnatal visit, and lactation consultants)	No charge
Emergency & urgent care
Emergency Department visit	30% coinsurance (after deductible)
Urgent care visit	$50 copay
Ambulance Service	30% coinsurance (after deductible)
Prescription drugs
(up to a 30-day supply)	$15 or 50% (whichever is greater)
Other services
Vision exams	30% coinsurance
Vision hardware allowance (applies to lenses, frames, and/or contacts every 24 months)	Not covered
Dental plans	Optional coverage available