KP GA Signature Gold 1700/25

Plan Type: HMO
Plan Tier: Gold
Individual Deductible $1,700
Family Deductible $3,400
Individual Out of Pocket Max $8,500
Family Out of Pocket Max $17,000
Primary Care Visit: $25
Specialist Visit: $55
Emergency Room: 30% Coinsurance after deductible
Hospital - Physician: 30% Coinsurance after deductible
Hospital - Facility: 30% Coinsurance after deductible
Link to Full SBC:
Plan Brochure:

Other Coverage:

Child Dental: No
Adult Dental No

Prescription Drug Pricing:

Generic Drugs: $15
Non-Preferred Brand Drugs: 45% Coinsurance after deductible
Preferred Brand Drugs: $50 Copay after deductible
Specialty Drugs: 45% Coinsurance after deductible
Summary of Benefits

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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