Kaiser Permanente Dual Complete South P7 (HMO D-SNP)

Kaiser Permanente Dual Complete South P7 (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 South Plan 7. This plan received an overall rating of 4 out of 5 stars in 2026.

It's important to know that Kaiser Permanente Dual Complete South P7 (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.

Key Plan Facts

Below are a few key facts and commonly-asked questions about Kaiser Permanente Dual Complete South P7 (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.

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:

Drug Coverage

The Kaiser Permanente Dual Complete South P7 (HMO D-SNP) prescription drug plan offers an Enhanced Alternative benefit with no drug deductible. During the initial coverage phase, you will enjoy no copay for Tier 1 preferred generic drugs at standard pharmacies and through standard mail. For Tier 2 standard generic drugs, the plan features a 5% coinsurance at standard pharmacies and no coinsurance for standard mail delivery. For Tier 3 preferred brands and Tier 4 non-preferred drugs, you will pay a 25% coinsurance, while Tier 5 specialty drugs have no copay at standard pharmacies. If you qualify for the Low-Income Subsidy (LIS), your Part D premium is reduced to $0. After your yearly out-of-pocket drug costs reach $2,100, you enter the catastrophic coverage phase and pay nothing for covered Medicare Part D drugs.

Additional Benefits

The Kaiser Permanente Dual Complete South P7 (HMO D-SNP) offers highly comprehensive medical coverage, featuring no copays and no coinsurance for a wide range of essential services. Members enjoy no-cost benefits for inpatient hospital stays, outpatient care, primary and specialist visits, and emergency services. Vision care is also covered with no copays, including routine eye exams and a generous $500 annual allowance for eyewear. While most core medical services are fully covered, a few specific benefits require minor cost-sharing, such as a $10 copay for ambulance services. Dialysis services require 20% coinsurance, while durable medical equipment may carry up to 20% coinsurance with no copay. It is important to note that this plan does not cover routine dental care, hearing services, or transportation.