Kaiser Permanente Dual Complete North P22 (HMO D-SNP)

Kaiser Permanente Dual Complete North P22 (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 22. 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 P22 (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 P22 (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 P22 (HMO D-SNP) offers an Enhanced Alternative drug benefit with no prescription drug deductible. Beneficiaries enjoy no copay for Tier 1 preferred generic, Tier 2 standard generic, and Tier 5 specialty tier drugs filled at standard pharmacies. Additionally, individuals who qualify for the low-income subsidy can reduce their Part D premium to zero dollars. For other tiers, the plan charges an 18% coinsurance for Tier 3 preferred brand drugs and a 25% coinsurance for Tier 4 non-preferred drugs. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase where you pay nothing for Medicare Part D covered drugs. This structured coverage ensures predictable costs for your essential prescription medications.

Additional Benefits

The Kaiser Permanente Dual Complete North P22 (HMO D-SNP) plan offers robust coverage for core medical needs, featuring no copays or coinsurance for primary care visits, preventive services, and outpatient hospital procedures. For inpatient hospital stays, members pay a daily copay of $475 for acute care and $405 for psychiatric care during the first five days, with no copays required for subsequent days. Emergency room visits carry a $115 copay, which is waived if admitted, while urgently needed care is available with no copay. While routine hearing services and transportation are not covered, this plan provides routine vision exams with no copay and a $350 annual allowance for eyewear. Members also benefit from covered home health services and a quarterly $75 over-the-counter allowance with no copays or coinsurance. Diagnostic tests and medical equipment generally require no copays, though some durable medical equipment and dialysis services may incur a coinsurance of up to 20 percent.