Kaiser Permanente Dual Complete North P23 (HMO D-SNP)

Kaiser Permanente Dual Complete North P23 (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 23. 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 P23 (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 P23 (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 P23 (HMO D-SNP) offers an Enhanced Alternative drug benefit with no prescription drug deductible. During the initial coverage phase, which lasts until total drug costs reach $2,100, members pay no copay for preferred generic, standard generic, and specialty tier drugs at standard pharmacies. Preferred brand drugs require an 18% coinsurance, while non-preferred drugs carry a 25% coinsurance at standard pharmacies and through standard mail. Once your yearly out-of-pocket drug costs reach $2,100, you enter the catastrophic coverage phase where you pay nothing for Medicare Part D covered drugs. Additionally, individuals who qualify for the low-income subsidy, also known as Extra Help, can benefit from a reduced Part D premium of $0.

Additional Benefits

The Kaiser Permanente Dual Complete North P23 (HMO D-SNP) offers comprehensive medical coverage with no copays and no coinsurance for primary care visits, preventive care, and outpatient hospital services. For inpatient stays, members pay a copay for the first five days ($475 for acute and $405 for psychiatric stays) and no copay for subsequent days. Emergency care is available with a $115 copay, which is waived if admitted, while urgently needed services require no copay. This plan also features no copays or coinsurance for home health services, routine eye exams, and Medicare-covered dental care, alongside a $350 annual allowance for eyewear. While dialysis services require a 20% coinsurance with no copay, durable medical equipment and prosthetics require no copay and a coinsurance ranging from 0% to 20%. Skilled nursing facility stays are also covered with no copay for the first 20 days and a daily copay of $214 for days 21 through 100.