Kaiser Silver 70 HMO

Kaiser Permanente Silver 70 HMO is ACA compliant.

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Kaiser Permanente's Silver 70 HMO - Available 01/01/18

The Kaiser Permanente Silver 70 HMO plan in California has a $2500 individual and a $5000 family medical deductible and pharmacy deductible of $250 per person and $500 for family in network. All covered services contribute to the out-of-pocket maximum. Preventive care services, such as routine physical exams and mammogram screenings, are at no charge. This is the most popular Kaiser plan in California and will satisfy your mandated individual health insurance requirement also known as minimum essential health coverage.  

Plan Name Silver 70 HMO
Medical Deductible Individual:$2,500 Family:$5,000
Drug Benefits Deductible $250 brand
Annual Out-of-Pocket Silver 70 HMO
Out of Pocket Max for Med and Drug Benefits (Total) Individual:$7,000 Family:$14,000
Emergency Health Silver 70 HMO
Urgent Care Centers or Facilities $35 Copay
Emergency Room Services $350 Copay
Emergency Transportation/Ambulance $250 Copay after deductible
Home Health Care Silver 70 HMO
Home Health Care Services $45 Copay
Hospitalization Services Silver 70 HMO
Inpatient Physician and Surgical Services 20% Coinsurance after deductible
Habilitation Services Inpatient: 20% Coinsurance after deductible; Outpatient: $35 Copay
Inpatient Hospital Services (e.g., Hospital Stay) 20% Coinsurance after deductible
Skilled Nursing Care 20% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services $35 Copay per vist, 20% Coinsurance up to $35 for outpatient services
Substance Abuse Disorder Inpatient Services 20% Coinsurance after deductible
Maternity Care Silver 70 HMO
Delivery and All Inpatient Services for Maternity Care 20% Coinsurance after deductible
Prenatal and Postnatal Care No Charge deductible waived
Other Services Silver 70 HMO
Mental/Behavioral Health Inpatient Services 20% Coinsurance after deductible
Durable Medical Equipment 20% Coinsurance
Hospice Services No Charge deductible waived
Mental/Behavioral Health Outpatient Services $35 Copay per visit, 20% Coinsurance up to $35 other outpatient services
Rehabilitative Occupational and Rehabilitative Physical Therapy Inpatient: 20% Coinsurance after deductible; Outpatient: $35 Copay
Outpatient Services Silver 70 HMO
Outpatient Surgery Physician/Surgical fees 20% Coinsurance
Outpatient Facility Fee (e.g., Ambulatory Surgery Center) 20% Coinsurance
Prescription Drug Coverage Silver 70 HMO
Generic Drugs $15 after $130 pharmacy deductible
Non-Preferred Brand Drugs $55 after $130 pharmacy deductible
Preferred Brand Drugs $55 after $130 pharmacy deductible
Specialty Drugs 20% after $130 pharmacy deductible, up to $250 per prescription
Preventative Care Silver 70 HMO
Well Baby Visits and Care No Charge deductible waived
Preventive Care/Screening/Immunization No Charge deductible waived
Professional Services Silver 70 HMO
Imaging (CT/PET scans, MRI's) $300 Copay
Specialist Visit $75 Copay
Diagnostic Test (X-Ray and Lab Work) $35 Copay
Primary Care Visit to Treat an Injury or Illness $35 Copay

When receiving medical attention, you must only use a Kaiser Permanente medical facility unless it is a medical emergency. Click here for Kaiser Permanente physician and location information.

Information contained in this website is limited in scope, subject to change without notice, and does not contain all the terms, conditions, limitations, or exclusions of the referenced benefit plans. Only the insurance company Plan Documents and Policy's contain the exact terms and conditions of coverage.

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