KP Cascade Gold - 23371WA1940001 Health Insurance Plan

Kaiser Foundation Health Plan of the Northwest health insurance plan with the Plan ID 23371WA1940001. The plan is called KP Cascade Gold.

Based on the AV Calculator by CMS.gov, the plan has an actuarial value of 100.00% (we converted the output of AV Calculator to percentage to compare with data provided by Issuer, it shows the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 0.00% of the costs of all covered benefits (according to the AV Calculator by CMS.gov). More information about AV Calculator methodology.

Health Insurance Plan ID 23371WA1940001
Health Insurance Plan Year 2024
State Washington
Health Insurance Issuer Kaiser Foundation Health Plan of the Northwest
Health Insurance Plan Variant 23371WA1940001-02
Provider Network(s) ['WAN001']
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Thu, 21 Nov 2024 00:44 GMT).

Providers Washington All US States
All N/A N/A
PCP N/A N/A
Allergy N/A N/A
OB/GYN N/A N/A
Dentists N/A N/A
Available Variants of the Health Plan

Standard On Exchange Plan - 23371WA1940001-01

Open to Indians below 300% FPL - 23371WA1940001-02

Open to Indians above 300% FPL - 23371WA1940001-03

Last Plan Update Date Mon, 12 Feb 2024 00:00 GMT
Last Import Date Thu, 21 Nov 2024 00:44 GMT

KP Cascade Gold Health Insurance Plan Variant 23371WA1940001-02 Attributes

Plan Attribute Value
AV Calculator Output Number 1
Business Year 2024
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Zero Cost Sharing Plan Variation
Dental Only Plan No
Design Type Not Applicable
Disease Management Programs Offered Pregnancy, High Blood Pressure & High Cholesterol, Pain Management, Depression, Low Back Pain, Diabetes, Heart Disease, Asthma
EHB Percent of Total Premium 99%
First Tier Utilization 100%
Formulary ID WAF017
HIOS Product ID 23371WA194
Import Date 2/12/2024
HSA Eligible No
IsItANewPlan Existing
Notice Required for Pregnancy No
Is a Referral Required for Specialist? Yes
Issuer ID 23371
Market Coverage Individual
Medical Drug Deductibles Integrated Yes
Medical Drug Maximum Out of Pocket Integrated Yes
Metal Level Gold
Multiple In Network Tiers No
National Network No
Network ID WAN001
Out of Country Coverage Yes
Out of Country Coverage Description Emergency medical conditions, including prescription drugs.
Out of Service Area Coverage Yes
Out of Service Area Coverage Description Emergency medical conditions, including prescription drugs.
Plan Effective Date 1/1/2024
Plan Expiration Date 12/31/2024
Plan ID (Standard Component ID with Variant) 23371WA1940001-02
Plan Marketing Name KP Cascade Gold
Plan Type EPO
Plan Variant Marketing Name KP Cascade Gold
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $0
SBC Scenario, Having a Baby, Copayment $0
SBC Scenario, Having a Baby, Deductible $0
SBC Scenario, Having a Baby, Limit $0
SBC Scenario, Having Diabetes, Coinsurance $0
SBC Scenario, Having Diabetes, Copayment $0
SBC Scenario, Having Diabetes, Deductible $0
SBC Scenario, Having Diabetes, Limit $0
SBC Scenario, Treatment of a Simple Fracture, Coinsurance $0
SBC Scenario, Treatment of a Simple Fracture, Copayment $0
SBC Scenario, Treatment of a Simple Fracture, Deductible $0
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Service Area ID WAS001
Source Name SERFF
Specialist Requiring a Referral A referral is not required for outpatient Services provided in the following departments: Cancer Counseling, Chemical Dependency Services., Mental Health Services., Obstetrics/Gynecology, Occupational Health., Ophthalmology, and Optometry (routine eye exams), and Social Services.
Plan ID 23371WA1940001
State Code WA
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family per person not applicable | per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual Not Applicable
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family $0 per person | $0 per group
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual $0
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance 0.00%
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family $0 per person | $0 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual $0
TEHBDedOutofNetFamily $0 per person | $0 per group
Combined Medical and Drug EHB Deductible, Out of Network, Individual $0
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family $0 per person | $0 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $0
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family per person not applicable | per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual Not Applicable
Unique Plan Design No
Version Number 1
Wellness Program Offered Yes

Copay & Coinsurance of KP Cascade Gold Health Insurance Plan, 23371WA1940001

Drug Tier Pharmacy Type Copay amount Copay option Coinsurance rate Coinsurance option Mail Order

Frequently Asked Questions(FAQ) about KP Cascade Gold, 23371WA1940001 Health Insurance Plan, 23371WA1940001

  • Does KP Cascade Gold Health Insurance Plan, 23371WA1940001 support Mail Ordering?

    Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.

  • Does (23371WA1940001) Health Insurance Plan, Variant (23371WA1940001-02) offer Disease Management Programs?

    Yes, and here is the list of available programs: Pregnancy, High Blood Pressure & High Cholesterol, Pain Management, Depression, Low Back Pain, Diabetes, Heart Disease, Asthma

    Does (23371WA1940001) Health Insurance Plan, Variant (23371WA1940001-02) have Out Of Country Coverage?

    Yes. Details: Emergency medical conditions, including prescription drugs.

    Does (23371WA1940001) Health Insurance Plan, Variant (23371WA1940001-02) have Out of Service Area Coverage?

    Yes. Details: Emergency medical conditions, including prescription drugs.

    Does (23371WA1940001) Health Insurance Plan, Variant (23371WA1940001-02) offer Disease Management Programs?

    Yes, and here is the list of available programs: Pregnancy, High Blood Pressure & High Cholesterol, Pain Management, Depression, Low Back Pain, Diabetes, Heart Disease, Asthma

    Does KP Cascade Gold Health Insurance Plan, Variant (23371WA1940001-02) offer Disease Management Programs for Asthma?

    Yes, the KP Cascade Gold Health Insurance Plan Variant 23371WA1940001-02 offers Disease Management Program for Asthma.

    Does KP Cascade Gold Health Insurance Plan, Variant (23371WA1940001-02) offer Disease Management Programs for Heart disease?

    Yes, the KP Cascade Gold Health Insurance Plan Variant 23371WA1940001-02 offers Disease Management Program for Heart disease.

    Does KP Cascade Gold Health Insurance Plan, Variant (23371WA1940001-02) offer Disease Management Programs for Depression?

    Yes, the KP Cascade Gold Health Insurance Plan Variant 23371WA1940001-02 offers Disease Management Program for Depression.

    Does KP Cascade Gold Health Insurance Plan, Variant (23371WA1940001-02) offer Disease Management Programs for Diabetes?

    Yes, the KP Cascade Gold Health Insurance Plan Variant 23371WA1940001-02 offers Disease Management Program for Diabetes.

    Does KP Cascade Gold Health Insurance Plan, Variant (23371WA1940001-02) offer Disease Management Programs for High blood pressure & high cholesterol?

    Yes, the KP Cascade Gold Health Insurance Plan Variant 23371WA1940001-02 offers Disease Management Program for High blood pressure & high cholesterol.

    Does KP Cascade Gold Health Insurance Plan, Variant (23371WA1940001-02) offer Disease Management Programs for Low back pain?

    Yes, the KP Cascade Gold Health Insurance Plan Variant 23371WA1940001-02 offers Disease Management Program for Low back pain.

    Does KP Cascade Gold Health Insurance Plan, Variant (23371WA1940001-02) offer Disease Management Programs for Pregnancy?

    Yes, the KP Cascade Gold Health Insurance Plan Variant 23371WA1940001-02 offers Disease Management Program for Pregnancy.

 

Disclaimer: This is based on the import(Date: Thu, 21 Nov 2024 00:44 GMT) of the data from Healthcare Issuers listed by CMS. While we make every effort to ensure that data is accurate, you should assume all results are unvalidated. Source: CMS.gov, HealthPorta HEALTHCARE MRF API