KP OR Dental 80L - 71287OR0590003 Health Insurance Plan

Kaiser Foundation Healthplan of the NW health insurance plan with the Plan ID 71287OR0590003. The plan is called KP OR Dental 80L.

Health Insurance Plan ID 71287OR0590003
Health Insurance Plan Year 2023
State Oregon
Health Insurance Issuer Kaiser Foundation Healthplan of the NW
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 71287OR0590003-00
Provider Network(s) ['ORN004']
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Wed, 27 Mar 2024 12:10 GMT).

Providers Oregon 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 Off Exchange Plan - 71287OR0590003-00

Standard On Exchange Plan - 71287OR0590003-01

Last Plan Update Date Fri, 12 Aug 2022 00:00 GMT
Last Import Date Wed, 27 Mar 2024 12:10 GMT

Benefits of KP OR Dental 80L Health Insurance Plan, 71287OR0590003-00

Benefit Covered In Network Out Of Network
Accidental Dental
NO
Basic Dental Care - Adult
YES

50.00% Coinsurance after deductible

100.00%
Basic Dental Care - Child
YES

50.00% Coinsurance after deductible

100.00%
Dental Check-Up for Children

Periodic: 2 times per year.

YES

20.00%

100.00%
Major Dental Care - Adult
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)

Periodic: 2 times per year.

YES

20.00%

100.00%

KP OR Dental 80L Health Insurance Plan Variant 71287OR0590003-00 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 2023
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Standard Low Off Exchange Plan
Dental Only Plan Yes
EHB Apportionment for Pediatric Dental 0.7688
First Tier Utilization 100%
HIOS Product ID 71287OR059
Import Date 8/12/2022 20:01
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 $300 per group
Medical EHB Deductible, In Network (Tier 1), Family Per Person $100 per person
Medical EHB Deductible, In Network (Tier 1), Individual $100
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 $700 per group
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person $350 per person
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual $350
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 Low
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 Brochure URL
Plan Effective Date 1/1/2023
Plan Expiration Date 12/31/2023
Plan ID (Standard Component ID with Variant) 71287OR0590003-00
Plan Marketing Name KP OR Dental 80L
Plan Type EPO
Plan Variant Marketing Name KP OR Dental 80L
QHP/Non QHP Both
Service Area ID ORS004
Source Name SERFF
Plan ID 71287OR0590003
State Code OR
URL for Enrollment Payment URL

Copay & Coinsurance of KP OR Dental 80L Health Insurance Plan, 71287OR0590003

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

Frequently Asked Questions(FAQ) about KP OR Dental 80L, 71287OR0590003 Health Insurance Plan, 71287OR0590003

  • Does KP OR Dental 80L Health Insurance Plan, 71287OR0590003 support Mail Ordering?

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

  • Does (71287OR0590003) Health Insurance Plan, Variant (71287OR0590003-00) have Out Of Country Coverage?

    Yes. Details: Emergency Only

    Does (71287OR0590003) Health Insurance Plan, Variant (71287OR0590003-00) have Out of Service Area Coverage?

    Yes. Details: Emergency Only

 

Disclaimer: This is based on the import(Date: Wed, 27 Mar 2024 12:10 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