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Kaiser Permanente Dual Complete North P2 (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Kaiser Permanente Dual Complete North P2 (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 North P2 (HMO D-SNP) in 2025, please refer to our full plan details page.
Kaiser Permanente Dual Complete North P2 (HMO D-SNP) is a HMO D-SNP plan offered by Kaiser Foundation Health Plan, Inc. available for enrollment in 2025 to people living in North Plan 2. The overall rating for this plan is not yet available for 2025.
It's important to know that Kaiser Permanente Dual Complete North P2 (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 North P2 (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 North P2 (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 North P2 (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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9350.00 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:
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Drug Coverage
The Kaiser Permanente Dual Complete North P2 (HMO D-SNP) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you will pay no copay for preferred generic and standard generic drugs at standard pharmacies and mail order. You will pay 18% coinsurance for preferred brand drugs and 25% coinsurance for non-preferred drugs at standard pharmacies and mail order. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for Medicare Part D covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit.
Additional Benefits
The Kaiser Permanente Dual Complete North P2 (HMO D-SNP) plan offers a range of benefits with varying cost-sharing. This plan covers inpatient hospital stays with no copay for the first 100 days, and outpatient services such as hospital services and substance abuse treatment with no copay. Emergency services have a copay of $110, and ambulance services have a copay of $325. Preventive services, primary care, vision exams, and many other services have no copay. The plan also includes coverage for hearing exams, dental services, and home health services with no copay. Additionally, the plan covers medical equipment and home infusion services with no copay for many services, and a 20% coinsurance for dialysis services.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric care, are covered, with no copay for days 1-90 and days 91-999. Non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered. Outpatient hospital services, ambulatory surgical center services, individual and group sessions for outpatient substance abuse, and outpatient blood services have no copay. Observation Services have a copay between $0.00 and $110.00.
Partial Hospitalization See details
Partial Hospitalization is covered by the Kaiser Permanente Dual Complete North P2 (HMO D-SNP) plan, and a doctor referral is required. There is no copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Kaiser Permanente Dual Complete North P2 (HMO D-SNP) plan, including both ground and air ambulance services, each with a $325 copay and no coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered by the Kaiser Permanente Dual Complete North P2 (HMO D-SNP) plan. Emergency Services have a $110 copay and no coinsurance, while Urgently Needed Services have no copay and no coinsurance. Worldwide Emergency Coverage has a $110 copay, Worldwide Urgent Coverage has no copay, and Worldwide Emergency Transportation has a $325 copay, and all have no coinsurance.
Primary Care See details
The Kaiser Permanente Dual Complete North P2 (HMO D-SNP) plan covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, additional telehealth benefits, opioid treatment program services, and physical therapy and speech-language pathology services with no copay. Routine chiropractic care is not covered, and podiatry services are not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered services, annual physical exams with no copay, and additional preventive services, with specific services like Health Education, Nutritional/Dietary Benefit, Fitness Benefit, and Remote Access Technologies covered with no copay. Other services like In-Home Safety Assessment, Personal Emergency Response System (PERS), and others are not covered. Kidney Disease Education Services are covered with no copay, along with other preventive services like Glaucoma Screening, Diabetes Self-Management Training, and more, all with no copay.
Hearing Services See details
Hearing services are partially covered by the Kaiser Permanente Dual Complete North P2 (HMO D-SNP) plan. Hearing exams have no copay, but routine hearing exams and fitting/evaluation for hearing aids are not covered, as are prescription hearing aids and OTC hearing aids.
Vision Services See details
Vision services include eye exams with no copay, and eyewear with a combined maximum benefit of $350 every year, but upgrades are not covered. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames are also covered.
Dental Services See details
Dental Services are covered, with no copay for Medicare Dental Services, but prior authorization and a doctor referral are required. Orthodontic, Restorative, Adjunctive General, Endodontics, Periodontics, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, Implant Services, Oral and Maxillofacial Surgery, and Orthodontics services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. There is no copay for Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs.
Dialysis Services See details
Dialysis Services are covered by the Kaiser Permanente Dual Complete North P2 (HMO D-SNP) plan. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, is covered under the Kaiser Permanente Dual Complete North P2 (HMO D-SNP) plan. Durable medical equipment has a coinsurance between 0% and 20%, while the plan has no copay. Prosthetic devices and medical supplies have no copay and no coinsurance, while diabetic supplies have no copay, and diabetic therapeutic shoes/inserts have no coinsurance. Durable medical equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by Kaiser Permanente Dual Complete North P2 (HMO D-SNP). Diagnostic Procedures/Tests and Lab Services have no copay, while Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Kaiser Permanente Dual Complete North P2 (HMO D-SNP) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Kaiser Permanente Dual Complete North P2 (HMO D-SNP) plan. A doctor referral is required for the services, but the plan does not cover any of the sub-services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Kaiser Permanente Dual Complete North P2 (HMO D-SNP) plan, requiring prior authorization and a doctor's referral. For days 1-100, there is no copay, but additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
The Kaiser Permanente Dual Complete North P2 (HMO D-SNP) plan covers acupuncture with no copay, and over-the-counter items with a maximum benefit of $140 every three months. Other services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and many others are not covered.
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