Kaiser Permanente Dual Complete North P20 (HMO D-SNP)

Kaiser Permanente Dual Complete North P20 (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 20. 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 P20 (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 P20 (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 P20 (HMO D-SNP) plan features an Enhanced Alternative drug benefit with a $615.00 annual prescription drug deductible. Individuals who qualify for the low-income subsidy (LIS) can reduce their Part D premium to $0.00. During the initial coverage phase, members enjoy no copay for Tier 1 preferred generic, Tier 2 standard generic, and Tier 5 specialty tier drugs at standard pharmacies. For Tier 3 preferred brand drugs, you will pay an 18% coinsurance, while Tier 4 non-preferred drugs require a 25% coinsurance at standard pharmacies and through standard mail. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for Medicare Part D covered drugs.

Additional Benefits

The Kaiser Permanente Dual Complete North P20 (HMO D-SNP) offers comprehensive coverage with many essential services requiring no copay and no coinsurance, including primary care, preventive screenings, and home health services. For hospital care, inpatient acute stays require a $450 copay for the first five days with no copay thereafter, while outpatient hospital services range from no copay up to a $475 copay. Emergency care is available with a $115 copay, which is waived upon admission, while urgently needed services feature no copay. Skilled nursing facility stays are covered with no copay for the first 20 days and a $214 daily copay for days 21 through 100. Routine eye exams feature no copay alongside a $350 annual allowance for eyewear, while Medicare-covered dental services and select hearing services are also available with no copay. Additionally, members can access over-the-counter items with a $75 allowance every three months and receive durable medical equipment with coinsurance ranging from 0% to 20%.