Oregon health plan · 2026

KP OR Gold 0/20 · 71287OR0420013

Kaiser Foundation Health Plan of the Northwest offers this marketplace plan (Plan ID 71287OR0420013). Use the modules below to compare premiums, coverage structure, provider access, and formulary context against alternative options in the same market.

Issuer: Kaiser Foundation Health Plan of the Northwest
Telehealth Data pending HSA eligible Check with issuer Dental Not listed Vision Not listed
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2026 cost summary

Key premiums & cost sharing

Rates mirror the latest CMS import (Tue, 10 Mar 2026 06:40 GMT). Personalize costs with your ZIP, age, and subsidies in the plan finder.

Monthly premium

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Before subsidies

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Deductible

N/A

N/A

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Max out-of-pocket

N/A

N/A

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Office visits

Primary care See benefits
Specialist See benefits

Drug tiers

Generic See drug coverage
Preferred brand See drug coverage

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Issuer profile See benefits
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Enrollment guidance

Stay on top of 2026 ACA deadlines

Open Enrollment window

Marketplace enrollment for 2026 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in Oregon). Submit changes before the deadline to avoid a coverage gap.

  • Enroll by Dec 15 for Jan 1 starts.
  • Finalize plan switches before the window closes.

Special Enrollment Periods

You can change plans mid-year if you experience a qualifying life event (move, childbirth, marriage, loss of other coverage).

  • Report the event within 60 days.
  • Keep documentation handy for Healthcare.gov or your state exchange.

CSR & subsidy reminders

Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.

  • Enter accurate income to maximize Advanced Premium Tax Credits.
  • Silver-tier CSR plans lower deductibles for households ≤250% FPL.

Thinking about switching?

Before you leave your current plan, compare networks, drug coverage, and total cost using the cards on this page.

  • Match provider networks so ongoing care isn’t disrupted.
  • Confirm prescriptions stay on-formulary or budget for tier changes.

Premium snapshot

Plan identifiers & filings

Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.

Plan ID 71287OR0420013
Coverage year 2026
State Oregon
Issuer Kaiser Foundation Health Plan of the Northwest
Formulary document Download formulary
Marketing materials View marketing kit
Last plan update Wed, 14 Sep 2022 00:00 GMT
Last HealthPorta import Tue, 10 Mar 2026 06:40 GMT

Network stats

Provider access snapshot

Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 10 Mar 2026 06:40 GMT).

All providers in Oregon 6086
PCPs in Oregon 542
Telehealth support Data pending
Nationwide providers 8984
6,086 doctors statewide 542 PCPs 49 OB/GYN

Provider network(s)

  • TIER-ONE-REFERRAL-REQUIRED
Providers Oregon All US states
All 6086 8984
PCP 542 782
Allergy 1 1
OB/GYN 49 64
Dentists N/A N/A

Drug coverage overview

2,716 drugs tracked

Inspect tier distribution plus authorization, step therapy, and quantity-limit counts sourced from HealthPorta’s formulary import.

Tier Covered drugs
GENERIC 1,830
SPECIALTY 505
NON-PREFERRED-BRAND 381
Prior authorization Drugs
Required 1,064
Not Required 1,652
Step therapy Drugs
Required 0
Not Required 2,716
Quantity limits Drugs
Has Limit 731
No Limit 1,985

Customer highlights

What stands out for members

  • Issuer: Kaiser Foundation Health Plan of the Northwest · Plan ID 71287OR0420013 · 2026 filing.
  • Download the latest formulary directly from the issuer here.
  • Review marketing brochures and SBC PDFs via the issuer marketing repository.
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Copay & coinsurance

Pharmacy cost sharing by tier

Drug tier Pharmacy type Copay amount Copay option Coinsurance rate Coinsurance option Mail order

Questions & answers

Frequently asked questions

How do I choose the right ACA plan in Oregon?

KP OR Gold 0/20 (71287OR0420013) is a marketplace plan from Kaiser Foundation Health Plan of the Northwest in Oregon for the 2026 coverage year.

Compare it against other options with the HealthPorta plan finder to confirm premiums, deductibles, and network access fit your household.

Does KP OR Gold 0/20 support telehealth or virtual urgent care?

The issuer has not published telehealth details yet. Review the Summary of Benefits and Coverage to confirm if virtual visits are included.

Is KP OR Gold 0/20 HSA-eligible and does it include dental or vision coverage?

HSA eligibility is not published; check the Summary of Benefits or ask the issuer.

Dental coverage is not listed for this plan.

Vision coverage is not listed for this plan.

Does KP OR Gold 0/20 support mail-order prescriptions?

Mail order coverage is not listed for this plan, so confirm with the issuer before relying on home delivery.

Disclaimer: Based on the Tue, 10 Mar 2026 06:40 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
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