KP GA Signature Silver 3500/20% HSA
| Plan Type: | HMO |
| Plan Tier: | Silver |
| Individual Deductible | $3,500 |
| Family Deductible | $7,000 |
| Individual Out of Pocket Max | $6,500 |
| Family Out of Pocket Max | $13,000 |
| Primary Care Visit: | 20% Coinsurance after deductible |
| Specialist Visit: | 20% Coinsurance after deductible |
| Emergency Room: | 20% Coinsurance after deductible |
| Hospital - Physician: | 20% Coinsurance after deductible |
| Hospital - Facility: | 20% Coinsurance after deductible |
| Link to Full SBC: | http://info.kaiserpermanente.org/healthplans/georgia/individual/pdfs/2021-ON-Exchange/KP_GA_Signature_Silver_3500_20_HSA.pdf |
| Plan Brochure: | http://info.kaiserpermanente.org/healthplans/planbrochures/2021/ga2021planbrochure.pdf |
Other Coverage:
| Child Dental: | No |
| Adult Dental | No |
Prescription Drug Pricing:
| Generic Drugs: | $15 Copay after deductible |
| Non-Preferred Brand Drugs: | 50% Coinsurance after deductible |
| Preferred Brand Drugs: | $50 Copay after deductible |
| Specialty Drugs: | 50% Coinsurance after deductible |
| Summary of Benefits | https://healthy.kaiserpermanente.org/content/dam/kporg/final/documents/formularies/ga/five-tier-formulary-benefit-ga-en-2021.pdf |
This Carrier Offers:
About The Carrier
Founded in 1945, Kaiser Permanente is recognized as one of America’s leading health care providers and not-for-profit health plans. We currently serve 12.4 million members in 8 states and the District of Columbia.
Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists, and team of caregivers.
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