Kaiser Permanente - Oregon 1500 HSA Option Plan Information
1500 HSA Option
Benefits Summary
Annual Individual Deductible $1,500 member
Annual Family Deductible $3,000 family
Annual out-of-pocket maximum - member $5,000 member
Annual out-of-pocket maximum - family $10,000 family
Hospital Care 20%
Primary Care Office Visits 20%
Specialist Office Visits 20%
Prescription Drugs $15 generic, $30 brand
Immunizations No charge
Allergy shots and other injections $5 per visit
Lab 20%
X-ray 20%
Pregnancy Services
Prenatal Care 20% (not subject to deductible)
Labor and Delivery (all necessary Participating Provider and hospital services) 20% coinsurance
Postpartum Care 20%
Emergency Services
Emergency Care 20%
Urgent Care 20%
Ambulance 20%
Mental Health Services
Mental Health Services- Inpatient Psychiatric Care 20% coinsurance
Mental health Services- Outpatient Psychiatric Care 20% coinsurance
Outpatient Services
Outpatient Surgery 20% coinsurance
Other Kaiser Permanente - Oregon health insurance plans:
