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Kaiser Permanente Dual Complete Oahu (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Kaiser Permanente Dual Complete Oahu (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Kaiser Permanente Dual Complete Oahu (HMO D-SNP) in 2026, please refer to our full plan details page.
Kaiser Permanente Dual Complete Oahu (HMO D-SNP) is a HMO D-SNP plan offered by Kaiser Foundation Health Plan, Inc. available for enrollment in 2026 to people living in Island of Oahu. The overall rating for this plan is not yet available for 2026.
It's important to know that Kaiser Permanente Dual Complete Oahu (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Kaiser Permanente Dual Complete Oahu (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Kaiser Permanente Dual Complete Oahu (HMO D-SNP).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Kaiser Permanente Dual Complete Oahu (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $615.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9250.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for Kaiser Permanente Dual Complete Oahu (HMO D-SNP)
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Drug Coverage
The Kaiser Permanente Dual Complete Oahu (HMO D-SNP) plan features an annual prescription drug deductible of $615. Under this plan, there is no copay for Tier 1 preferred generic and Tier 2 generic medications filled at standard pharmacies or through standard mail order. Additionally, Tier 6 vaccines are available with no copay for a one-month supply at standard pharmacies. For Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, you will be responsible for a 25% coinsurance. This 25% coinsurance rate applies to one, two, or three-month supplies filled at standard retail pharmacies as well as standard mail order.
Additional Benefits
The Kaiser Permanente Dual Complete Oahu (HMO D-SNP) plan offers comprehensive medical coverage with no coinsurance for inpatient, outpatient, and emergency hospital services. Inpatient acute stays require a $405 copay for days 1 to 6, a $70 copay for days 7 to 30, and no copay for stays beyond 30 days. Doctor visits are also straightforward, requiring a $40 copay for primary care and a $55 copay for specialists with no coinsurance. Many essential benefits like preventive care, home health services, and select dental care are covered with no copay and no coinsurance. For specialized medical needs, including dialysis, durable medical equipment, and Part B drugs, members will pay no copay and a coinsurance ranging up to 20%. Emergency care is accessible with a $115 copay, which is waived if you are admitted to the hospital within 24 hours.
Inpatient Hospital See details
Kaiser Permanente Dual Complete Oahu (HMO D-SNP) covers inpatient acute and psychiatric hospital services with no coinsurance, though upgrades and non-Medicare-covered stays are not covered. Acute stays require a $405 copay for days 1 to 6, a $70 copay for days 7 to 30, and no copay for days 31 and beyond, while psychiatric stays require a $340 copay for days 1 to 6, a $15 copay for days 7 to 90, and no copay for additional days.
Outpatient Services See details
Outpatient services are covered by Kaiser Permanente Dual Complete Oahu (HMO D-SNP) with no coinsurance, though copays apply to certain services including $0 to $300 for outpatient hospital visits, $300 for ambulatory surgical centers, and $40 to $50 for outpatient substance abuse sessions. There is no copay or coinsurance for observation and outpatient blood services, although referrals are required for most of these benefits.
Partial Hospitalization See details
Partial hospitalization is covered by Kaiser Permanente Dual Complete Oahu (HMO D-SNP) with no coinsurance, though a referral is required. Depending on the service, you will pay a copay of either $40.00 to $50.00 or $105.00.
Ambulance and Transportation Services See details
Kaiser Permanente Dual Complete Oahu (HMO D-SNP) covers ground and air ambulance services with a $400 copay and no coinsurance, though transportation services to health-related locations are not covered.
Emergency Services See details
Emergency services under the Kaiser Permanente Dual Complete Oahu (HMO D-SNP) are covered with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours, while urgently needed services require a $40 copay and no coinsurance. For worldwide emergency services, some services are covered, but worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered.
Primary Care See details
Kaiser Permanente Dual Complete Oahu (HMO D-SNP) covers primary care visits with a $40 copay and specialist visits with a $55 copay, both with no coinsurance. Physical, occupational, and speech therapies are covered with a $35 copay and no coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services are partially covered by Kaiser Permanente Dual Complete Oahu (HMO D-SNP), featuring no coinsurance for all services and no copay for annual physical exams, fitness benefits, and glaucoma screenings. While many benefits require a referral, a $40 copay applies to kidney disease education and a $30 copay applies to post-welcome visit EKGs, while sub-services like in-home safety assessments, personal emergency response systems (PERS), and medical nutrition therapy are not covered.
Hearing Services See details
Kaiser Permanente Dual Complete Oahu (HMO D-SNP) covers hearing exams with a $40 copay, no coinsurance, and no deductible, though a referral is required. Routine hearing exams, hearing aid fittings, and all prescription and over-the-counter hearing aids are not covered under this plan.
Vision Services See details
Vision services are covered by Kaiser Permanente Dual Complete Oahu (HMO D-SNP) with a $0 to $40 copay and no coinsurance for eye exams, and no copay with 20% coinsurance for eyewear. While some services are covered, routine eye exams, other eye exam services, contact lenses, eyeglasses, eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by Kaiser Permanente Dual Complete Oahu (HMO D-SNP), offering preventive, diagnostic, restorative, and periodontal care with no copay and no coinsurance, though Medicare-covered dental services require a $55 copay and no coinsurance. Endodontics, removable and fixed prosthodontics, maxillofacial prosthetics, implant services, oral and maxillofacial surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Kaiser Permanente Dual Complete Oahu (HMO D-SNP) covers home infusion bundled services, including insulin with no copay and no coinsurance. Medicare Part B chemotherapy, radiation, and other Part B drugs are also covered with no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Kaiser Permanente Dual Complete Oahu (HMO D-SNP) covers Dialysis Services with no copay and coinsurance ranging from no coinsurance up to 20%. A referral is required to access these covered services.
Medical Equipment See details
Kaiser Permanente Dual Complete Oahu (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copay and prior authorization required. Depending on the item, members will pay between no coinsurance and 20% coinsurance for these covered services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Kaiser Permanente Dual Complete Oahu (HMO D-SNP) with no coinsurance, though a referral is required. Members will pay a $30 copay for lab services, diagnostic procedures, outpatient x-rays, and diagnostic radiological services, and a minimum copay of $85 for therapeutic radiological services.
Home Health Services See details
Home health services are covered under the Kaiser Permanente Dual Complete Oahu (HMO D-SNP) with no copay and no coinsurance, though a referral is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Kaiser Permanente Dual Complete Oahu (HMO D-SNP) with no copay and no coinsurance, though only some services are covered as standard cardiac, intensive cardiac, pulmonary, and SET for PAD services are not covered. A referral is required to receive these services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Kaiser Permanente Dual Complete Oahu (HMO D-SNP) with no coinsurance, requiring a referral but no prior three-day hospital stay. There is no copay for days 1 to 20 and days 41 to 100, while days 21 to 40 require a $218 daily copay, with no coverage provided for days beyond the standard 100-day limit.
Other Services See details
Kaiser Permanente Dual Complete Oahu (HMO D-SNP) partially covers other services, featuring residential chemical dependency services with a $340.00 to $2040.00 copay and no coinsurance, alongside non-Medicare durable medical equipment with no copay and a 20% coinsurance. Acupuncture, over-the-counter items, and meal benefits are not covered under this plan.
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