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Kaiser Permanente Dual Complete Maui (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Kaiser Permanente Dual Complete Maui (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 Maui (HMO D-SNP) in 2026, please refer to our full plan details page.
Kaiser Permanente Dual Complete Maui (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 Maui. The overall rating for this plan is not yet available for 2026.
It's important to know that Kaiser Permanente Dual Complete Maui (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 Maui (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 Maui (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 Maui (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 Maui (HMO D-SNP)
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Drug Coverage
The Kaiser Permanente Dual Complete Maui (HMO D-SNP) plan features an annual drug deductible of $615. Under this plan, you will pay no copay for Tier 1 preferred generic and Tier 2 generic drugs 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 higher-tier medications, cost-sharing is structured as a percentage of the drug cost. Members pay a 17% coinsurance for Tier 3 preferred brand drugs at standard pharmacies and standard mail order. Tier 4 non-preferred drugs and Tier 5 specialty drugs both require a 25% coinsurance for one-month, two-month, or three-month supplies.
Additional Benefits
Kaiser Permanente Dual Complete Maui (HMO D-SNP) provides robust medical coverage featuring no coinsurance for inpatient hospital stays, outpatient services, and doctor visits. Primary care visits require a $40 copay, specialists require a $55 copay, and emergency room visits have a $115 copay that is waived upon immediate admission. Inpatient hospital stays carry daily copays, such as $405 per day for the first six days of an acute stay, with no coinsurance. Many essential services are available with no copay and no coinsurance, including annual physical exams, preventive dental care, and home health services. For other specialized care, members pay no copay and up to 20% coinsurance for durable medical equipment, diabetic supplies, and dialysis. Vision exams are covered with no coinsurance and copays ranging from no copay up to $40.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Kaiser Permanente Dual Complete Maui (HMO D-SNP) with no coinsurance, as upgrades and non-Medicare-covered stays are not covered. For covered acute stays, there is a $405 daily copay for days 1 to 6 and $70 daily for days 7 to 30, while psychiatric stays require a $340 daily copay for days 1 to 6 and $15 daily for days 7 to 90, with no copays for additional days.
Outpatient Services See details
Kaiser Permanente Dual Complete Maui (HMO D-SNP) covers outpatient services with no coinsurance, including outpatient hospital services with a $0 to $300 copay and ambulatory surgical center services with a $300 copay. Outpatient substance abuse sessions require a $40 to $50 copay and no coinsurance, while outpatient blood and observation services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Kaiser Permanente Dual Complete Maui (HMO D-SNP) covers partial hospitalization services with no coinsurance, though a referral is required. Depending on the service, you will pay a copay ranging from $40.00 to $105.00.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by Kaiser Permanente Dual Complete Maui (HMO D-SNP), which offers Medicare-covered ground and air ambulance services for a $400 copay and no coinsurance. Routine transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
Kaiser Permanente Dual Complete Maui (HMO D-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are not covered.
Primary Care See details
Kaiser Permanente Dual Complete Maui (HMO D-SNP) covers primary care physician services with a $40 copay and no coinsurance, and specialist visits with a $55 copay and no coinsurance. Physical and occupational therapy require a $35 copay and no coinsurance, telehealth and opioid treatment are offered with no copay and no coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
Kaiser Permanente Dual Complete Maui (HMO D-SNP) offers partially covered preventive services with no coinsurance, featuring no copay for annual physical exams, fitness benefits, and select screenings, though a $30 copay applies to post-welcome visit EKGs and a $40 copay applies to kidney disease education. Sub-services not covered under this benefit include in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, home safety devices, and counseling.
Hearing Services See details
Kaiser Permanente Dual Complete Maui (HMO D-SNP) offers partially covered hearing exams with a $40 copay, no coinsurance, and no deductible, though routine exams and fitting evaluations are not covered. Some prescription hearing aid services are covered, but all specific types, including inner ear, outer ear, and over-the-ear devices, as well as over-the-counter hearing aids, are not covered.
Vision Services See details
Kaiser Permanente Dual Complete Maui (HMO D-SNP) provides vision benefits featuring a copay ranging from no copay to $40 and no coinsurance for eye exams, alongside no copay and a 20% coinsurance for eyewear. Although some services are covered, routine and other eye exams, contact lenses, eyeglasses, lenses, frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by Kaiser Permanente Dual Complete Maui (HMO D-SNP), featuring no copay and no coinsurance for preventive, diagnostic, periodontic, and restorative care, while Medicare-covered dental services require a $55 copay and no coinsurance. Several sub-services are not covered, including endodontics, prosthodontics, implants, oral and maxillofacial surgery, and orthodontics.
Home Infusion bundled Services See details
Kaiser Permanente Dual Complete Maui (HMO D-SNP) covers Home Infusion bundled Services with no copay for all covered drugs, including insulin, chemotherapy, and other Part B drugs. Enrollees pay no coinsurance for insulin, while other Part B chemotherapy, radiation, and miscellaneous drugs carry a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Kaiser Permanente Dual Complete Maui (HMO D-SNP) covers dialysis services with no copay and coinsurance ranging from no coinsurance to 20%. A referral is required to access these covered services.
Medical Equipment See details
Kaiser Permanente Dual Complete Maui (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copay and coinsurance ranging from no coinsurance up to 20%. Prior authorization is required for these covered benefits, which do not restrict you to specific vendors or manufacturers.
Diagnostic and Radiological Services See details
Kaiser Permanente Dual Complete Maui (HMO D-SNP) covers diagnostic and radiological services with no coinsurance, though a referral is required. Members pay a $30 copay for lab services, diagnostic tests, X-rays, and diagnostic radiological services, while therapeutic radiological services require a minimum copay of $85.
Home Health Services See details
Home health services are covered by Kaiser Permanente Dual Complete Maui (HMO D-SNP) with no copay and no coinsurance, although a referral is required.
Cardiac Rehabilitation Services See details
Kaiser Permanente Dual Complete Maui (HMO D-SNP) covers some services with no coinsurance and a referral, but cardiac rehabilitation (with a $30 copay), intensive cardiac rehabilitation (with a $30 copay), pulmonary rehabilitation (with a $25 copay), and SET for PAD services (with a $20 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Kaiser Permanente Dual Complete Maui (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a referral and allowing admission without a prior three-day hospital stay. There is no copay for days 1 to 20 and days 41 to 100, a $218 copay for days 21 to 40, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Kaiser Permanente Dual Complete Maui (HMO D-SNP) partially covers other services, excluding acupuncture, over-the-counter items, and meal benefits. Covered benefits include residential chemical dependency services for a $340.00 to $2040.00 copay and no coinsurance, as well as durable medical equipment not covered by Medicare for no copay and 20% coinsurance.
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