KP OR Family Dental - $1000/$50 Ded - 71287OR0590001 Health Insurance Plan
Kaiser Foundation Healthplan of the NW health insurance plan with the Plan ID 71287OR0590001. The plan is called KP OR Family Dental - $1000/$50 Ded.
| Health Insurance Plan ID | 71287OR0590001 | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Health Insurance Plan Year | 2025 | ||||||||||||||||||
| State | Oregon | ||||||||||||||||||
| Health Insurance Issuer | Kaiser Foundation Healthplan of the NW | ||||||||||||||||||
| Health Insurance Plan Variant | 71287OR0590001-01 | ||||||||||||||||||
| Provider Network(s) | TIER-ONE-REFERRAL-REQUIRED TIER-ONE | ||||||||||||||||||
| In Network Doctors
*The data available in our database based on Health Insurance Company Open Data (update: Thu, 21 Nov 2024 00:44 GMT). |
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| Available Variants of the Health Plan | |||||||||||||||||||
| Last Plan Update Date | Thu, 17 Oct 2024 00:00 GMT | ||||||||||||||||||
| Last Import Date | Thu, 21 Nov 2024 00:44 GMT |
Benefits of KP OR Family Dental - $1000/$50 Ded Health Insurance Plan, 71287OR0590001-01
| Benefit | Covered | In Network | Out Of Network |
|---|---|---|---|
| Accidental Dental
|
NO | ||
| Basic Dental Care - Adult
Limit: 1000.0 Dollars per Year This benefit subject to a $1,000 combined Annual Benefit Max |
YES | 20.00% Coinsurance after deductible |
100.00% |
| Basic Dental Care - Child
|
YES | 20.00% Coinsurance after deductible |
100.00% |
| Dental Check-Up for Children
Periodic: 2 times per year. |
YES | $0.00 |
100.00% |
| Major Dental Care - Adult
Limit: 1000.0 Dollars per Year This benefit subject to a $1,000 combined Annual Benefit Max |
YES | 50.00% Coinsurance after deductible |
100.00% |
| Major Dental Care - Child
|
YES | 50.00% Coinsurance after deductible |
100.00% |
| Orthodontia - Adult
|
NO | ||
| Orthodontia - Child
Limited to Orthodontia for cleft palate or cleft lip only |
YES | 50.00% Coinsurance after deductible |
100.00% |
| Routine Dental Services (Adult)
Limit: 1000.0 Dollars per Year Periodic: 2 times per year. |
YES | $0.00 |
100.00% |
KP OR Family Dental - $1000/$50 Ded Health Insurance Plan Variant 71287OR0590001-01 Attributes
| Plan Attribute | Value |
|---|---|
| Begin Primary Care Cost-Sharing After Number Of Visits | 0 |
| Begin Primary Care Deductible Coinsurance After Number Of Copays | 0 |
| Business Year | 2025 |
| Child-Only Offering | Allows Adult and Child-Only |
| Composite Rating Offered | No |
| CSR Variation Type | Standard High On Exchange Plan |
| Dental Only Plan | Yes |
| EHB Apportionment for Pediatric Dental | 0.9298 |
| First Tier Utilization | 100% |
| HIOS Product ID | 71287OR059 |
| Import Date | 2024-10-17 20:01:47 |
| Inpatient Copayment Maximum Days | 0 |
| Guaranteed Rate | Guaranteed Rate |
| New/Existing Plan | Existing |
| Issuer ID | 71287 |
| Issuer Marketplace Marketing Name | Kaiser Permanente |
| Market Coverage | Individual |
| Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Group | per group not applicable |
| Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Person | per person not applicable |
| Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out | Not Applicable |
| Medical EHB Deductible, Combined In/Out of Network, Family Per Group | per group not applicable |
| Medical EHB Deductible, Combined In/Out of Network, Family Per Person | per person not applicable |
| Medical EHB Deductible, Combined In/Out of Network, Individual | Not Applicable |
| Medical EHB Deductible, In Network (Tier 1), Family Per Group | $150 per group |
| Medical EHB Deductible, In Network (Tier 1), Family Per Person | $50 per person |
| Medical EHB Deductible, In Network (Tier 1), Individual | $50 |
| Medical EHB Deductible, Out of Network, Family Per Group | per group not applicable |
| Medical EHB Deductible, Out of Network, Family Per Person | per person not applicable |
| Medical EHB Deductible, Out of Network, Individual | Not Applicable |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Group | $850 per group |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person | $425 per person |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual | $425 |
| Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Group | per group not applicable |
| Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Person | per person not applicable |
| Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Individual | Not Applicable |
| Metal Level | High |
| Multiple In Network Tiers | No |
| National Network | No |
| Network ID | ORN004 |
| Out of Country Coverage | Yes |
| Out of Country Coverage Description | Emergency Only |
| Out of Service Area Coverage | Yes |
| Out of Service Area Coverage Description | Emergency Only |
| Plan Effective Date | 2025-01-01 |
| Plan Expiration Date | 2025-12-31 |
| Plan ID (Standard Component ID with Variant) | 71287OR0590001-01 |
| Plan Marketing Name | KP OR Family Dental - $1000/$50 Ded |
| Plan Type | EPO |
| Plan Variant Marketing Name | KP OR Family Dental - $1000/$50 Ded |
| QHP/Non QHP | Both |
| Service Area ID | ORS004 |
| Source Name | SERFF |
| Plan ID | 71287OR0590001 |
| State Code | OR |
| URL for Enrollment Payment | URL |
Copay & Coinsurance of KP OR Family Dental - $1000/$50 Ded Health Insurance Plan, 71287OR0590001
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
|---|
Frequently Asked Questions(FAQ) about KP OR Family Dental - $1000/$50 Ded, 71287OR0590001 Health Insurance Plan, 71287OR0590001
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Does KP OR Family Dental - $1000/$50 Ded Health Insurance Plan, 71287OR0590001 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (71287OR0590001) Health Insurance Plan, Variant (71287OR0590001-01) have Out Of Country Coverage?
Does (71287OR0590001) Health Insurance Plan, Variant (71287OR0590001-01) have Out of Service Area Coverage?
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