Kaiser Permanente Dual Complete North P18 (HMO D-SNP)

Kaiser Permanente Dual Complete North P18 (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 North Plan 18. This plan received an overall rating of 4 out of 5 stars in 2026.

It's important to know that Kaiser Permanente Dual Complete North P18 (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 North P18 (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 North P18 (HMO D-SNP) offers an Enhanced Alternative drug benefit with a yearly prescription drug deductible of $615.00. If you qualify for the Low-Income Subsidy (LIS), your Part D cost-sharing is reduced to $0. After meeting your deductible, you will pay copayments or coinsurance until your total drug costs reach $2,100.00. During the initial coverage phase, you will pay no copay for Tier 1 preferred generic drugs and Tier 5 specialty drugs at standard pharmacies. Tier 2 standard generic drugs require 10% coinsurance, while Tier 3 preferred brand and Tier 4 non-preferred drugs carry a 25% coinsurance. After your yearly out-of-pocket costs reach $2,100.00, you enter catastrophic coverage and pay nothing for Medicare Part D covered drugs.

Additional Benefits

The Kaiser Permanente Dual Complete North P18 (HMO D-SNP) plan offers comprehensive coverage with no copays or coinsurance for primary care, specialist visits, and preventive services like annual physicals. For inpatient hospital stays, members pay a daily copay for the first five days ($475 for acute care and $405 for psychiatric care) with no copay for subsequent days, while outpatient hospital copays range from no copay up to $475. Emergency room visits require a $115 copay, which is waived if admitted within 24 hours, and urgent care services are available with no copay. The plan also provides no-copay benefits for routine eye exams and eyewear up to a $350 annual allowance, as well as Medicare-covered dental care and home health services with no copays or coinsurance. However, hearing services, routine dental procedures, and transportation are not covered under this plan. Diagnostic labs and diabetic supplies have no copay, while durable medical equipment and dialysis services require no copay but carry up to 20% coinsurance.