Kaiser Permanente - Oregon Gold Plan Plan Information
Gold Plan
Benefits Summary
Annual Individual Deductible $500, $1,000 member
Annual Family Deductible $1,500 family
Annual out-of-pocket maximum - member $3,750 member
Annual out-of-pocket maximum - family $11,250 family
Hospital Care $750 per day up to $3,750 per admission
Primary Care Office Visits $25 primary care (not subject to deductible)
Specialist Office Visits $35 specialist office visits
Prescription Drugs 50% up to $150 maximum for 30-day supply ($500 deductible)
Immunizations No charge
Allergy shots and other injections $5 per visit
Lab $15
X-ray $25
Pregnancy Services
Prenatal Care $25 per visit (not subject to deductible)
Postpartum Care $25 per visit (not subject to deductible)
Emergency Services
Emergency Care $100
Urgent Care $25
Ambulance $75
Mental Health Services
Mental Health Services- Inpatient Psychiatric Care $500 per day up to $2,500 per admission (up to 10 days)
Mental health Services- Outpatient Psychiatric Care $35 per visit (maximum 20 visits)
Outpatient Services
Outpatient Surgery $150
Other Kaiser Permanente - Oregon health insurance plans:
