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Kaiser Permanente Colorado – 5000 HSA-Qualified Deductible Plan (100%) – COLORADO
A comparison of the 5000 HSA-Qualified Deductible Plan (100%) offered by Kaiser Permanente Colorado is detailed out below for both Network and Non-Network coverage.
| Network | Non-Network | |
|---|---|---|
|
||
| Network | See Provider | See Provider |
| Application | 5000 HSA-Qualified Deductible Plan (100%) Application | 5000 HSA-Qualified Deductible Plan (100%) Application |
| Brochure | 5000 HSA-Qualified Deductible Plan (100%) Brochure | 5000 HSA-Qualified Deductible Plan (100%) Brochure |
| Copay | No charge per visit after deductible is met | No charge per visit after deductible is met |
| Office Visit | No charge per visit after deductible is met | No charge per visit after deductible is met |
| Deductible | $5,000 Individual / $10,000 Family | $5,000 Individual / $10,000 Family |
| Coinsurance | 100% | 100% |
| Coinsurance Limit | 5000 HSA-Qualified Deductible Plan (100%) | 5000 HSA-Qualified Deductible Plan (100%) |
| Out-of-Pocket Maximum | $5,000 Individual / $10,000 Family | $5,000 Individual / $10,000 Family |
| Lifetime Maximum | Unlimited lifetime coverage | Unlimited lifetime coverage |
| Prescription Drugs | Not covered | Not covered |
| Emergency Room | No charge | No charge |
| Adult Preventative Care | No charge | No charge |
| Child Preventative Care | No charge | No charge |
| Lab / X-Ray | No charge | No charge |
| Maternity | Not covered | Not covered |
| Physical Therapy | 5000 HSA-Qualified Deductible Plan (100%) | 5000 HSA-Qualified Deductible Plan (100%) |
| Skilled Nursing | 5000 HSA-Qualified Deductible Plan (100%) | 5000 HSA-Qualified Deductible Plan (100%) |
| Home Health Care | 5000 HSA-Qualified Deductible Plan (100%) | 5000 HSA-Qualified Deductible Plan (100%) |
| Mental Health | 5000 HSA-Qualified Deductible Plan (100%) | 5000 HSA-Qualified Deductible Plan (100%) |
| Hospital Care | No charge per admission | No charge per admission |
| Optional Benefits | 5000 HSA-Qualified Deductible Plan (100%) | 5000 HSA-Qualified Deductible Plan (100%) |