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Oregon Medical Insurance > Kaiser Permanente of Oregon > Dental Plans

Kaiser Permanente of Oregon

Optional Dental Plan Rates & Benefits
  Plan 1 Plan 2 Plan 3
Benefit maximum None None None
Deductible (individual/family) $50/$150 $50/$150 $100/$300
Benefits Member pays
Preventive and diagnostic services* No charge 20% 20%
Basic restorative services 50% 50% 50%
Oral surgery, endodontics, and periodontics 75% 75% 75%
Major restorative services 75% 75% 75%
Orthodontics (for children and adults 75% 75% 75%

*Not subject to the deductible
Monthly Premium 0-24 25-44 45+
Plan 1
Subscriber only $39.53 $41.90 $44.27
Subscriber + spouse/domestic partner

$79.06

 $83.80 $88.54
Subscriber + child(ren) $79.06 $81.43 $83.80
Subscriber, spouse, + child(ren) $118.59 $123.33 $128.07
Plan 2
Subscriber only $35.58 $37.71 $39.85
Subscriber + spouse/domestic partner $71.16 $75.42 $79.70
Subscriber + child(ren) $71.16 $73.29 $75.43
Subscriber, spouse, + child(ren) $106.74 $111.00 $115.28
Plan 3
Subscriber only $32.76 $34.73 $36.69
Subscriber + spouse/domestic partner $65.52 $69.46 $73.38
Subscriber + child(ren) 465.52 $67.49 $69.45
Subscriber, spouse, + child(ren) $98.28 $102.22 $106.14

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
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