KP GA Signature Bronze 6500/40%/HSA
| Plan Type: | HMO |
| Plan Tier: | Expanded Bronze |
| Individual Deductible | $6,500 |
| Family Deductible | $13,000 |
| Individual Out of Pocket Max | $6,900 |
| Family Out of Pocket Max | $13,800 |
| Primary Care Visit: | 40% Coinsurance after deductible |
| Specialist Visit: | 40% Coinsurance after deductible |
| Emergency Room: | 40% Coinsurance after deductible |
| Hospital - Physician: | 40% Coinsurance after deductible |
| Hospital - Facility: | 40% Coinsurance after deductible |
| Link to Full SBC: | http://info.kaiserpermanente.org/healthplans/georgia/individual/pdfs/2021-ON-Exchange/KP_GA_Signature_Bronze_6500_40_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: | 40% Coinsurance after deductible |
| Non-Preferred Brand Drugs: | 50% Coinsurance after deductible |
| Preferred Brand Drugs: | 50% Coinsurance 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 |
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