Kaiser Permanente Dual Complete South P11 (HMO D-SNP)

Kaiser Permanente Dual Complete South P11 (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 11. 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 P11 (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 P11 (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 P11 (HMO D-SNP) offers an Enhanced Alternative drug benefit with a $0 prescription drug deductible. During the initial coverage phase, members enjoy no copay for Tier 1 through Tier 4 drugs at standard pharmacies and through standard mail, as well as no copay for Tier 5 specialty drugs at standard pharmacies. These cost-sharing benefits apply for 30-day supplies until total drug costs reach $2,100.00. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and will pay nothing for covered Medicare Part D drugs. Additionally, qualifying for the low-income subsidy, or Extra Help, can reduce your Part D premium to $0.00.

Additional Benefits

The Kaiser Permanente Dual Complete South P11 (HMO D-SNP) offers robust coverage with no copays and no coinsurance for most major medical services, including inpatient and outpatient hospital care, emergency services, and doctor visits. This plan features no deductibles on key benefits and fully covers home health, medical equipment, and diagnostic testing at no cost. Dialysis is one of the few services requiring a cost-share, which is covered with no copay and a 20% coinsurance. For supplemental care, the plan provides routine eye exams and eyewear up to a $500 annual limit with no copay, alongside Medicare-covered dental services and preventive care with no copay or coinsurance. Additionally, members can access acupuncture, fitness benefits, and an over-the-counter allowance of $235 every three months with no copay. While many services require doctor referrals or prior authorizations, this plan maximizes savings by eliminating out-of-pocket costs for the vast majority of covered healthcare benefits.